when is 100 cm not 100 cm? [was Re: DS vs RNY ]

[Guest guest]

Steve,

That is good info. Dr. Anthone (who does the DS open) mentioned that

when he measures the total intestinal length, he doesn't strecth it

out as much so he mearues 600cm typically instead of 750cm. So using

that proportion I would guess that maybe you common limb is 125cm

effectively. I think more research should be done on longer than

100cm channels to see if the reduction in weight loss is significant.

Now 200cm is clearly too long, but it might be that 125cm is a good

length for avoiding any problems related to bowel movements. I am

tempted to as Dr. Anthone to make my common channel that long, as my

srating BMI is only 44, but on the other hand, maybe I should leave

it up to him to judge.

Hull

--- In duodenalswitch@y..., Steve Goldstein <steve-goldstein@c...>

>

>

> At a recent support group meeting, Dr. Elariny said something of

> considerable interest re limb and channel lengths in the way he

(and

> unnamed others, apparently) do lap surgeries. He measures the

common

> channel at 100 cm without stretching out the intestine the way that

> it could be done with open surgery. This is because the small

> grippers that would be needed to stretch out segments of intestine

in

> lap surgery would probably also injure the intestine. So, the 100

cm

> of in situ intestine with lap is longer than the 100 cm of

stretched

> out intestine for open surgery. This helps me understand, in part,

> why my weight loss may not be happening as fast as with some others

> (I had a lap DS), although some folks with the sleeve (vertical

> gastrectomy alone) are losing faster than I. It also makes me feel

> more confident that my malabsorption may not be as severe over the

> long haul, though perhaps at the expense of weight maintenance.

> That's a tradeoff that I am willing to make for myself, personally

> (others will undoubtedly have their own personal choices).

>

> Another interesting sidelight: when he measures the alimentary

limb,

> nominally at 250 cm, he might lengthen it a bit so that,

> anatomically, it will mate up at the duodenal stub without placing

> strain on the intestine or the mesentery (blood vessels feeding the

> intestines).

>

> --Steve

> --

> Steve Goldstein, age 61

> Lap BPD/DS on May 2, 2001

> Dr. Elariny, INOVA Fairfax Hospital, Virginia

> Starting (05/02/01) BMI = 51

> BMI on 09/12 = 41 (-63 lb.)

[Guest guest]

At 7:34 PM +0000 9/13/01, chull1@... wrote:

>Steve,

>... it might be that 125cm is a good

>length for avoiding any problems related to bowel movements.

Funny, but in the initial patient orientation, I asked about getting

a 125 cm common channel, and Dr. Elariny answered that more than 100

cm wouldn't help much as far as more absorption goes--he obviously

did not mean that 200 cm would not mean more absorption. So, it

looks as if I got what I asked for, though in a very roundabout way.

Nevertheless, I have had considerable problems with steatorrhea and

gas, though FiberCon seems to have helped a great deal.

Good luck,

Steve

--