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Re: Bypass

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Since the length of the intestinal tract varies from 18' to 20',

measuring the length of tract bypassed is not a very accurate method to

estimate how long the resulting common channel, the part where nutrients

and digestive juices mix, will be. The only clinical definition, of

which I am aware, is based on length of the remaining common channel

regardless of the amount of intestinal tract that has been bypassed.

In, Kushner, R. MD, Managing the Obese Patient After Bariatric Surgery:

A Case Report of Severe Malnutrition and Review of the Literature,

Journal of Parenteral and Enternal Nutrition, Vol 9 Issue 2, 2000, pp

126-132, it is stated that if the remaining jejunum is 101 " + (255 cm+)

in length, it is referred to as being a proximal RNY. A remaining

jejunum length of 61 " to 100 " (153 to 254 cm) is a medial RNY. A

remaining jejunum length of 40 " to 60 " (101 to 152 cm) is a distal RNY.

The word " jejunum " is used as a catch-all for the combined length of

jejunum and ileum. After a distal procedure, only part of the ileum

will be available for the common channel.

I believe there is 2.54 cm to an inch. If you had a 20', or 609 cm,

intestinal tract, the bypassing of 180 cm would leave a common channel

of 429 cm. An 18', or 548 cm, intestinal tract would have a remaining

368 cm common channel. Using Dr. Kushner's definition, with either

beginning length, the result would still be a proximal RNY.

Ray Hooks

For WLS nutrition info, visit

http://www.bariatricsupplementsystem.com

Creighton wrote:

>

> Hi Everyone,

> What is 180 cm considered when bypassed? A distal or medial?And what is the

longest a surgeon can bypass.

> Thanks,

> in SC

>

>

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