Pre-op appt. and common channel revisted

[Guest guest]

Hi all,

I had my pre-op appointment and attended the informational seminar

with Dr. Sudan in Omaha last Thursday. I was pleased with the

appointment itself and the amount of information he covered during

the seminar. They are filing with my insurance . My primary

insurance, a self-insured type through work, has a very specific

exclusion. However, my secondary, CHAMPVA, will pay! I'm hoping to

have my surgery the first week in December.

The only issue I wanted to ask all of you about is the common channel

length. I did go back through archives, but still have a question.

Dr. Sudan makes the common channel 50cm. He wants to give you the

best chance upfront to lose weight; any revisions, according to him,

are much more risky. He said that his patients have not had problems

with diarrhea. In reading the posts, it seems that many post-ops

have a 100 cm common channel.

Does anyone have a 50 cm? Any advice from you post-ops on this

issue? Thanks for your help!

(BTW - if you get this 2x's, I apologize in advance!

Beverly

Pre-OP, Dr. Sudan

BMI 45

[Guest guest]

Beverly,

The original Scopinaro procedure used 50cm, but frequent revisons

were required due to protient malnutrion.

However, there are two other major variables that you should find out:

What it the total length of the alimentary limb. The original

procedure picked a fixed 250cm length, but most suregons do either a

40%/60% split (longer bilio limb) or a 50%/50% split (equal

alimentary and billo limbs).

The final variable is the gastric volume. Typical gastric volume is

about 100-150ml. However, Scopinaro had to modify the gastric volume

up to 200-300ml in order to prevent problems with protien

malnutrition.

Most suregons scale the common channel length with the total

intestinal length choosing 50cm only for those with very short

intestines or who have very high BMI's.

Try to find out all three of the variables (gastric volume,

alimentary limb length, and common limb length), and then we can

access the appropriateness of the choice.

Another factor is your eating habits. Do you like high protien foods?

Scopinaro found that those in Northern Italy (who are more wealthy

and eat more meat) suffered far fewer problems with protien

malnutrion than those from Southern Italy (who primarily eat pasta).

Scopinaro then adjusted the gastric volume appropriately (200ml for

the North, 300ml for the south).

Most other suregons like to keep the gastric volume small (except for

Dr. Marceau in Quebec) at about 125ml and then tailor the limb

lengths. Dr. Anthone likes to make the gastric volume " as small as

possible, consistant with proper functioning " , but he uses equal

length limbs to reduce the amount of malabsorption of the procedure.

Hull

> Hi all,

>

> I had my pre-op appointment and attended the informational seminar

> with Dr. Sudan in Omaha last Thursday. I was pleased with the

> appointment itself and the amount of information he covered during

> the seminar. They are filing with my insurance . My primary

> insurance, a self-insured type through work, has a very specific

> exclusion. However, my secondary, CHAMPVA, will pay! I'm hoping

to

> have my surgery the first week in December.

>

> The only issue I wanted to ask all of you about is the common

channel

> length. I did go back through archives, but still have a

question.

> Dr. Sudan makes the common channel 50cm. He wants to give you the

> best chance upfront to lose weight; any revisions, according to

him,

> are much more risky. He said that his patients have not had

problems

> with diarrhea. In reading the posts, it seems that many post-ops

> have a 100 cm common channel.

>

> Does anyone have a 50 cm? Any advice from you post-ops on this

> issue? Thanks for your help!

>

> (BTW - if you get this 2x's, I apologize in advance!

>

> Beverly

> Pre-OP, Dr. Sudan

> BMI 45