Guest guest Posted June 28, 2001 Report Share Posted June 28, 2001 In a message dated 06/28/2001 10:10:31 AM Central Daylight Time, Willyangel@... writes: << A friend of mine saw Dr.Gagner today and asked him about the 75cc common channel. He said he does 100cc because there is no literature proving that 75cc offers any additional significant benifit. Well, my question is, is there? I would like the 75cc but since I've researched everything else I guess I should look into this too. Does anyone know of anything that points to a significant benifit of a 75c= >> I would possibly call Dr. Hess's office and ask to talk to him about it. I heard (just through grapevine, not sure where) that Dr. Hess quit doing 100 cm common channels routinely and has gone back to mostly 75 and some 50s. He must have had a reason for this. My common channel is only 50 cm and I am very happy with it. Dawn--Chicago metro--south Dr. Hess, Bowling Green, OH BPD/DS www.duodenalswitch.com 267 to 165 5'4 " size 22 to size 10 have made size goal, weight goal may need to be adjusted. no more high blood pressure, sore feet, or dieting! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 28, 2001 Report Share Posted June 28, 2001 Hi all, A friend of mine saw Dr.Gagner today and asked him about the 75cc common channel. He said he does 100cc because there is no literature proving that 75cc offers any additional significant benifit. Well, my question is, is there? I would like the 75cc but since I've researched everything else I guess I should look into this too. Does anyone know of anything that points to a significant benifit of a 75c= c channel over the 100cc? Also,Dr. Gagner did his first revision this week, to a 50cc commone channel. He said he did it WITH Dr.REN? Did my friend hear correctly? She says she is sure he said they BOTH did it. But she is postop and on pain meds. Anybody know about this? I'll probably call office or email them tomorrow anyway. Thanks all. Sincerely, Will Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 28, 2001 Report Share Posted June 28, 2001 I am pretty sure Dr. Gagner said Dr. Quinn assisted. It sounds kind of like Ren. Dr. Quinn is Dr. Gagners fellow and assists on his surgeries. She is an amzing doctor and she will be joining the practice in September. Jill K in NY 4/5/01 Gagner & Quinn -63.5 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 28, 2001 Report Share Posted June 28, 2001 Will, There IS a difference with a 75 common channel compared to a 100.....another list mate got the 100 common channel and has lost very slowly and is very discouraged and wants a revision. Mine is 80cm and Ive lost 75 lbs in less than 7 months with less than 25 lbs to go. Judie Any Proof?/Revision Hi all, A friend of mine saw Dr.Gagner today and asked him about the 75cc common channel. He said he does 100cc because there is no literature proving that 75cc offers any additional significant benifit. Well, my question is, is there? I would like the 75cc but since I've researched everything else I guess I should look into this too. Does anyone know of anything that points to a significant benifit of a 75c= c channel over the 100cc? Also,Dr. Gagner did his first revision this week, to a 50cc commone channel. He said he did it WITH Dr.REN? Did my friend hear correctly? She says she is sure he said they BOTH did it. But she is postop and on pain meds. Anybody know about this? I'll probably call office or email them tomorrow anyway. Thanks all. Sincerely, Will ---------------------------------------------------------------------- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 28, 2001 Report Share Posted June 28, 2001 Will, The common channel length is a topic I am also researching. One thing that is well known is that a shorter comman channel will lead to more problems with protien malabsorption. In the original BPD study by Scorapino they used a 50cm comman channel and reported 15% of the patients had protien malnutrition! Increasing the channel to 200-300cm reduces the rate to 2.3% and 0.8% respectively.. Most surgeons seem to use 100cm nowdays as a compromise. Unfortunately, I haven't found the data on weight loss effictiveness vs. channel length. The data I have seen for 50cm ,75cm, and 100cm channel lengths show little difference, but the data is very noisey (i.e. not enough data to draw a conclusion). Hess reported dissapointing early results in revision surgeries that shortend the common channel, but excellent results in terms of elminating protien malnutrition by lengthining the comman channel. The upshot of all this is that I would rather err on the side of a longer common channel (>100cm) for a first operation (just my opinion). The only risk is stopping short of your weight loss goal. That is something I can live with as long as my comorbidities are resolved. I am not looking to be thin, just healthy. I will continue the search for more hard data. Let us know if you find anything and I will do likewise. Hull > Hi all, > A friend of mine saw Dr.Gagner today and asked him about the 75cc > common channel. He said he does 100cc because there is no literature > proving that 75cc offers any additional significant benifit. > Well, my question is, is there? I would like the 75cc but since I've > researched everything else I guess I should look into this too. > Does anyone know of anything that points to a significant benifit of a 75c= > c channel over the 100cc? > Also,Dr. Gagner did his first revision this week, to a 50cc commone > channel. He said he did it WITH Dr.REN? > Did my friend hear correctly? She says she is sure he said they BOTH > did it. But she is postop and on pain meds. > Anybody know about this? > I'll probably call office or email them tomorrow anyway. > Thanks all. > Sincerely, > Will Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 28, 2001 Report Share Posted June 28, 2001 In a message dated 6/28/01 4:20:21 PM, duodenalswitch writes: << There IS a difference with a 75 common channel compared to a 100.....another list mate got the 100 common channel and has lost very slowly and is very discouraged and wants a revision. Mine is 80cm and Ive lost 75 lbs in less than 7 months with less than 25 lbs to go. >> Judie: I don't know if this is entirely due to common channel length... I mean, a gal who had surgery the same day as me (and at the same starting bmi, except a little lower) is losing much faster than me! We both have common channel lengths of 100 cm. I've also heard of other people with 100 cm channel lengths losing much faster than I have, even though I have the same 100 cm. I'm not saying your friend is not justified in being dissatisfied about his/her weight loss or even considering a revision at all. I'm just pointing out that there are many who do have 100 cm common channels who lose quite quickly whereas others don't and I think it's a complex interaction of factors involving metabolism, etc. I suspect that slow(er) weight loss may be related to the ways in which the body 'fights' the loss. I've noticed that I'll go through a rapid weight loss and then my body will fight back --- going up anwheres from 2-4 lbs and having a 'mini plateau' until the next loss cycle begins. It could also be th at my body is adjusting faster to the surgery (ie -- the common channel is elongating, growing new receptor cells, etc. at a more rapid weight and absorbing more at an earlier time than others). My surgeon also mentioned exercise routine: I do walk quite a bit and for extended distances but I don't go to a gym weekly or anything like that. Sure, people with shorter common channels may, on average, lose more faster. But, this can be seen in people who even have the same common channel length. Dr. Gagner said the same thing to me. I think his emphasis was that, in the end, there isn't much difference since both people will end up around their ideal weight by the time the weight loss window is 'closed' at 18 months. And, since both people will end up at that ideal weight range, he would rather give 20-25 cm more of intestine to combat malapsorption and perhaps make it a little easier to avoid nutritional deficiencies for the the rest of their lives. He isn't just thinking about how fast someone will lose but the lifelong consequences of having more common channel to absorb. I'm NOT saying that those with less than 100 cm suffer any more deficiencies or have any more problems than those with 100 cm. God knows that many people, no matter what their common channel length, can still be affected by gas, loose stools/etc. I think his point is to be on the safe side in terms of lifelong absorption issues. all the best, lap ds with gallbladder removal January 25, 2001 five months post-op and still feelin' fab! pre-op: 307 lbs/bmi 45 now: 241 lbs/bmi 34 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 28, 2001 Report Share Posted June 28, 2001 Dear Will, Here is an exceprt from the Abstract of the 1993 Marceau report (available from Dueodenalswitch website): " The biliopancreatic diverting intestinal limb was anastomosed to the nutrient ileal limb 100 cm proximal to the ileocecal valve instead of 50 cm proximal to it, thus doubling the length of the common ileal absorptive segment. Weight loss after either operation was greater than 70% of the inital excess weight. Following the new operation, there was a lesser prevalence of side effects, especially loose stools and malodorous gas, a lesser degree of hypocalcemia and no hypoalbuminemia. " 70% weight loss vs maybe 80% when 50cm is uesd. Not a bad tradeoff for the reduced risks. Of cousre your milage may vary. Hull > Hi all, > A friend of mine saw Dr.Gagner today and asked him about the 75cc > common channel. He said he does 100cc because there is no literature > proving that 75cc offers any additional significant benifit. > Well, my question is, is there? I would like the 75cc but since I've > researched everything else I guess I should look into this too. > Does anyone know of anything that points to a significant benifit of a 75c= > c channel over the 100cc? > Also,Dr. Gagner did his first revision this week, to a 50cc commone > channel. He said he did it WITH Dr.REN? > Did my friend hear correctly? She says she is sure he said they BOTH > did it. But she is postop and on pain meds. > Anybody know about this? > I'll probably call office or email them tomorrow anyway. > Thanks all. > Sincerely, > Will Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 28, 2001 Report Share Posted June 28, 2001 you have some good points . Dr Welker did tell me that he didnt see much difference between the 75 and 100 cm BUT that he felt the average person benefited better from an 80cm than the 100. He tailors the common channel to each individual and its a personal thing with each patient. I didnt ask for the 80cm but Im tickled to death he gave me what he thought was best for me! Also, he mentioned that the shorter common channel gives the best long term loss at keeping it off...... Judie Re: Re: Any Proof?/Revision > > In a message dated 6/28/01 4:20:21 PM, duodenalswitch writes: > > << There IS a difference with a 75 common channel compared to a > 100.....another > > list mate got the 100 common channel and has lost very slowly and is very > > discouraged and wants a revision. Mine is 80cm and Ive lost 75 lbs in less > > than 7 months with less than 25 lbs to go. > > >> > > Judie: I don't know if this is entirely due to common channel length... I > mean, a gal who had surgery the same day as me (and at the same starting bmi, > except a little lower) is losing much faster than me! We both have common > channel lengths of 100 cm. > > I've also heard of other people with 100 cm channel lengths losing much > faster than I have, even though I have the same 100 cm. I'm not saying your > friend is not justified in being dissatisfied about his/her weight loss or > even considering a revision at all. I'm just pointing out that there are > many who do have 100 cm common channels who lose quite quickly whereas others > don't and I think it's a complex interaction of factors involving metabolism, > etc. > > I suspect that slow(er) weight loss may be related to the ways in which the > body 'fights' the loss. I've noticed that I'll go through a rapid weight > loss and then my body will fight back --- going up anwheres from 2-4 lbs and > having a 'mini plateau' until the next loss cycle begins. It could also be th > at my body is adjusting faster to the surgery (ie -- the common channel is > elongating, growing new receptor cells, etc. at a more rapid weight and > absorbing more at an earlier time than others). My surgeon also mentioned > exercise routine: I do walk quite a bit and for extended distances but I > don't go to a gym weekly or anything like that. > > Sure, people with shorter common channels may, on average, lose more faster. > But, this can be seen in people who even have the same common channel length. > Dr. Gagner said the same thing to me. I think his emphasis was that, in the > end, there isn't much difference since both people will end up around their > ideal weight by the time the weight loss window is 'closed' at 18 months. > And, since both people will end up at that ideal weight range, he would > rather give 20-25 cm more of intestine to combat malapsorption and perhaps > make it a little easier to avoid nutritional deficiencies for the the rest of > their lives. He isn't just thinking about how fast someone will lose but the > lifelong consequences of having more common channel to absorb. I'm NOT > saying that those with less than 100 cm suffer any more deficiencies or have > any more problems than those with 100 cm. God knows that many people, no > matter what their common channel length, can still be affected by gas, loose > stools/etc. I think his point is to be on the safe side in terms of lifelong > absorption issues. > > all the best, > > lap ds with gallbladder removal > January 25, 2001 > > five months post-op and still feelin' fab! > > pre-op: 307 lbs/bmi 45 > now: 241 lbs/bmi 34 > > ---------------------------------------------------------------------- > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 28, 2001 Report Share Posted June 28, 2001 By the time we are all done with this, I can almost say we will be able to sit for the Medical Board Exams and have a good chance of passing! LOL E. Nahodil Woodbridge, VA DS in 2 parts - Dr. Elariny Date: TBA Re: Any Proof?/Revision Dear Will, Here is an exceprt from the Abstract of the 1993 Marceau report (available from Dueodenalswitch website): " The biliopancreatic diverting intestinal limb was anastomosed to the nutrient ileal limb 100 cm proximal to the ileocecal valve instead of 50 cm proximal to it, thus doubling the length of the common ileal absorptive segment. Weight loss after either operation was greater than 70% of the inital excess weight. Following the new operation, there was a lesser prevalence of side effects, especially loose stools and malodorous gas, a lesser degree of hypocalcemia and no hypoalbuminemia. " 70% weight loss vs maybe 80% when 50cm is uesd. Not a bad tradeoff for the reduced risks. Of cousre your milage may vary. Hull > Hi all, > A friend of mine saw Dr.Gagner today and asked him about the 75cc > common channel. He said he does 100cc because there is no literature > proving that 75cc offers any additional significant benifit. > Well, my question is, is there? I would like the 75cc but since I've > researched everything else I guess I should look into this too. > Does anyone know of anything that points to a significant benifit of a 75c= > c channel over the 100cc? > Also,Dr. Gagner did his first revision this week, to a 50cc commone > channel. He said he did it WITH Dr.REN? > Did my friend hear correctly? She says she is sure he said they BOTH > did it. But she is postop and on pain meds. > Anybody know about this? > I'll probably call office or email them tomorrow anyway. > Thanks all. > Sincerely, > Will ---------------------------------------------------------------------- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 28, 2001 Report Share Posted June 28, 2001 are we fat? yes! are we stupid? NOOOOOOO! > > Hi all, > > A friend of mine saw Dr.Gagner today and asked him about the > 75cc > > common channel. He said he does 100cc because there is no > literature > > proving that 75cc offers any additional significant benifit. > > Well, my question is, is there? I would like the 75cc but since > I've > > researched everything else I guess I should look into this too. > > Does anyone know of anything that points to a significant benifit > of a 75c= > > c channel over the 100cc? > > Also,Dr. Gagner did his first revision this week, to a 50cc > commone > > channel. He said he did it WITH Dr.REN? > > Did my friend hear correctly? She says she is sure he said they > BOTH > > did it. But she is postop and on pain meds. > > Anybody know about this? > > I'll probably call office or email them tomorrow anyway. > > Thanks all. > > Sincerely, > > Will > > > -------------------------------------------------------------------- -- > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 28, 2001 Report Share Posted June 28, 2001 Very funny. However, I can say that my medical education has been very useful in researching and reading about WLS. Since my focus has been mostly above the neck for some time, WLS has rekindled my interest in the below-the-head stuff. I have noticed many knowledgeable folks on this list who often remind me of something I've forgotten or teach me something new. What an education! No wonder we blow many surgeons away with our questions and awareness of our " right to know. " in Seattle ----- Original Message ----- > By the time we are all done with this, I can almost say we will be able to > sit for the Medical Board Exams and have a good chance of passing! LOL > > > E. Nahodil > Woodbridge, VA > DS in 2 parts - Dr. Elariny > Date: TBA Quote Link to comment Share on other sites More sharing options...
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