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In a message dated 11/09/2001 3:33:44 PM Central Standard Time,

mkf5t@... writes:

> Read another post about someone doing 60-75 cm. CCs. I thought

> 100 cm. was standard " safe " procedure. What's up? What IS the

> standard?

>

Dr. Hess most used common channel length is 75cm. I heard--not from him but

some other source so check it out before using to discuss with surgeon--that

Dr. Hess went to 100cm for a while but decided to go back to mostly 75cm.

Now he does it to the particular patient based on small bowel length

measurement, bmi, age, etc. My small intestine length was unusually short so

he made my common channel 50cm. I was kind of shocked at first but after he

explained it to me, I was GLAD he made it 50cm. Another reason I think he

makes shorter common channels can be seen in his study onthe ds website. In

this paper he indicated that individuals who end up with nutritional

deficiencies or continual diarrhea were relieved of their problems when a

revision was done and the common channel lengthened. However, those who had

inadequate weight loss were not helped that much by doing a revision to

shorten their common channel. Therefore, erring on the side of too short of

a common channel is more effectively fixed than an error on too long of a

common channel.

Dawn--South Suburban Chicago area

Dr. Hess, Bowling Green, OH

BPD/DS

4/27/00

www.duodenalswitch.com

267 to 165 5' 4 "

size 22 to size 10

have made size goal

no more high blood pressure, sore feet, or dieting

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I had an enlightening conversation with a doctor regarding the common

channel length. He stated that he had challanged and enlightened the

physician's at the recent Bariatric Seminar who's statements were

geared towards having no problem using a standard measurement for

common channel lengths. He argues that they can not use the standard

measurements of 75-100 cm common channel in either lap or open

procedures because the measurement (or eyeballing in the case of lap)

of the duodenum only does not take into consideration the " length " of

the stomach (in longer stomach's - top to bottom - you will have to

have a larger sized pouch and will need to accomodate for this in the

absorption area to promote weight loss)and therefore the capacity,

AND the actual " surface " of the intestine left to absorb in the

common channel (in thicker duodenums there is a greater absorption

field and the same 75 cm channel in another person would not be

absorbing as much). He has had patient's with extremely long and thin

duodenums where he has had to leave a much longer duodenum to account

for an adequate amount of absorption.

He stressed to the Bariatric Surgeons that they must start taking

into account all factors instead of relying on the standard 50-125cm

adjustments.

I made not have explained it as well as he did to me, but the jist of

it is there. I had not heard this type of argument before and

thought it would be helpful to everyone in making sure they are

getting their surgeries tailored to suit them SPECIFICALLY and not

being forced to be a part of the 50 to 125 cm squad.

Ellen W

> > >... Is a 100 cm lap the same as 75 open cm channel

> > >

> >

> > Not at all. I guess that my 100 cm lap would, if stretched out

as

> in

> > open, be more like 125 cm. And, I am losing rather slowly, too.

> > --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 10/25 = 39 (-75 lb.) -- No longer M.O.

> > Losing more slowly than most, but enjoying renewed health and

life

> in general.

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<<He argues that they can not use the standard

measurements of 75-100 cm common channel in either lap or open

procedures because the measurement (or eyeballing in the case of lap)

>>

I read my surgical report and spoke with my surgeon. When doing a

full lap BPD/DS, she does not " eyeball " the measurements. My

surgical reports says in part... " Using a 100 cm piece of umbilical

tape, 100 cm of ileum was measured proximal to the ileocecal valve,

where it was marked with a silk stitch. From this point, an

additional 150 cm of ileum was measured proximally, where it was

divided...... "

Jane J. 38 yrs. old

230/153 (-77 lbs) 5' 3.5 "

Lap BPD/DS

4/26/01

Dr. Ren

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> I had an enlightening conversation with a doctor regarding the

common

> channel length. He stated

Ellen who is the doctor you are referring to?

Thanks

Edee

pre-opt Chicago

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He is Dr. Hares in Bloomfield Hills MI. A truely wonderful

physician.

I have been to a total of four surgeons discussing the procedure.

The first did not do the DS, but was equally wonderful. The second

and third surgeon made me feel as if I was one in a herd of cattle

going in for the cut. I am sure they had the expertise, but I did

not feel as if I was being treated as an individual. The feeling of

being cattle started for me with the initial phone call to the office

and getting the standard " What's your weight, height, address, phone

number? Read the information we send you and call back for an

appointment. " I'd call back and get an appointment three months

later, only to have to sit through a seminar and then wait again to

see if I can get approved through insurance and then wait again to

get a surgery date.

Dr. Hares administration person, Carol, was warm from the very first

call. She got me in within 30 days. I did not have to sit in a

seminar, but actually sat with the DOCTOR and one other person for a

very personal and informative Q & A. The follow-up care director,

Jackie, is equally warm and accomodating. I have a date of 12/10/01,

pending insurance approval. I felt SO GOOD walking out of there!

The one-on-one attention of 100% was very comforting. The office is

busy and each person handles that pressure with such grace and

compassion for each patient. I highly recommend this office. (I am

sure there are other equally wonderful physician's out there. He's

just my choice.)

> > I had an enlightening conversation with a doctor regarding the

> common

> > channel length. He stated

>

> Ellen who is the doctor you are referring to?

>

> Thanks

> Edee

> pre-opt Chicago

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I had my surgery with Dr. Hares this past July. I have been very impressed with

the personal care I have gotten. I know there is a person that had a bad

experience with Dr. Hares when he first started doing the DS on his own, but he

has since done hundreds of them and everyone I have met has only had wonderful

things to say about him. Of course anyone that can help you lose a lot of

weight would look very good in your eyes. I have been losing very rapidly and

the office is keeping a close eye on me. If I don't report to them every 2

weeks, they call me to get a progress report. The support group also does a lot

of good things besides all the important informational stuff. Our next meeting

is a fashion show where post-op's model some of the latest clothes from a local

clothing store. The best part of this is that it makes the models feel good

about their progress. I am going to be one of the models and I am really

looking forward to it. The following meeting is another fashion show where

everyone we

ars their pre-op clothing. That should be pretty funny and really show how far

everyone has come.

When you are pre-op, it is very important to have a good surgeon and that you

feel confident with their skill. Right after surgery, you need a surgeon that

you can trust to take care of any complications that may arise. Now that I am 4

months out, having a group of people to help me through this time is so very

important. For those of us that can take part in local in-person support

groups, that is a wonderful way to get support. Otherwise, this list and others

like it can really make a world of difference in your emotional recovery.

Keep in mind that this is only my opinion and others may feel differently. I do

not have any medical training so I can only speak from my own experience.

Kathy M.

DS 7/19/01

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