200CM Common Channel

on 7/6/22 9:44 am

So I had my lap-band removed in March 2022, after 14 years, and surgury went very well. Recovery was a little painful for about one week because they have to excise the band out from the encapsulation. Surgeon said that there was no injury to the esophagus or stomach. Followup was perfect with no complications.

As I was considering revision surgery with my doctor...who is very experienced in all WLS, he suggested a DS versus just VSG for long term success, and I agree. However my concerns were long term malnutrition of nutrients and proteins due to malabsorption and being a lightweight with only a 37BMI, and many loose bowel movements per day that would affect quality of life. (I do understand the importance of protein and the vitamin protocols....so that's not an issue fo me. I will adhere to it.)

After much research and discussion with my doctor we concluded a common channel off 200cm would be best for my particular situation. Less concern about malabsorption, less loose bowel movements, same maximum weight loss as a standard or Hess DS surgery, but with a bit more chance of regain, (which I'm ok with that risk. I'm confident I will still get better long term results than VSG).

For me....I think the trade off of a little possible regain versus the higher risks of malnutrition complications is worth it for me. Even standard DS has some regain according to studies. Plus the outcome will still be much better than VSG alone....which has even more regain. Its not discussed to often but the trend is to make the cc longer now because of all of the things I mentioned. So that's where I stand right now....

So I guess what this little rant is about.... is.... finding out if anyone has any first hand knowledge of having a longer cc......150, 200, I;ve even heard for 230. I'd love to hear your experience.

on 7/8/22 4:24 am
WLS on 07/15/22

Hi there!

I'm still pre op but will be getting the SADI/SIPS/loop switch in a week. My pre op appointment is Monday, and I'll get to ask more questions there.

However, my manual says this clinic measures out 300cm, so I'm assuming that means I'll have a common channel of that length. Since half the point of the loop switch is a longer common channel to stave off the deficiencies that were much more common with the traditional DS, this makes sense to me.

I'm with you - super worried about the possibility of deficiencies across the board. That, and the fewer complications, are a couple of the reasons I opted for the loop switch over the traditional DS.

Guess I'll know more on Monday. Happy to talk about this, though! Cheers!

on 7/8/22 4:32 am

Good luck on Monday! I would have preferred the Single/Loop versus the standard DS, but my health coverage does not cover that surgery yet. However, I think with a 200cm cc versus the usual 100-150, it'll definitely be beneficial. I've heard of people pushing to get as short as a 50cm cc....which IMHO is drastic. Best of luck on your journey!

on 7/8/22 4:59 am
WLS on 07/15/22

Ahh, that would do it. I hear this procedure is not widely covered, yet. It was one of the questions I'd specifically asked my health insurance case manager since it wasn't listed as covered in our benefits. I called it modified switch and she said yes. Everything else has been through my surgery clinic and them, so guess I'm lucky there. My practice still calls it the DS and I'm always particular about calling it out, just in case.

If you weren't able to go with loop switch, I'd say a 200cm common channel is amazing for the traditional version as a compromise. If your surgeon is able to make that adjustment, good for you! You know yourself better than they do. I'd think that since the results of the loop switch are so similar to the DS with an even longer channel, that could be an indicator that you'll still get great results with the benefit of less potential issues.

Yes, I've read about some people who want the shortest channel possible and I know everyone's cir****tances are different but...too many possible side effects. Like you said, spending your life in the bathroom wouldn't be fun. And the protein, vitamin, and mineral deficiencies are so much more common the shorter you go. We're already playing on hard mode...personally wouldn't want to add that in.

And thanks! I'm super nervous but this is long overdue. Best of luck on your journey, and congratulations on finding a surgeon who will work with you! Cheers.

on 7/10/22 8:24 pm

Good luck and it's a great choice. I had it done in NY in 2014, and have kept all the weight off and I'm the most fit I've been in 30 years. It's one step at a time though over a few years.

on 7/11/22 6:23 am
WLS on 07/15/22

Thank you! Appreciate the feedback. Its good to hear the experiences of others. Congratulations on your sustained weight loss. Such an achievement.

282 at referral, 280 at consult, 249 on 7/15 for SADI surgery

Loss: Pre-op-33, M1-12, M2-17, M3-14, M4-11, M5-14, M6-5

Today's weight: 170.8

on 7/8/22 6:01 pm

While I don't have a longer common channel (mine is 85 cm), I would advise you to join Facebook DS support groups if you haven't already to get more anecdotal testimonies before proceeding. Can you succeed with a longer CC? Yes. Will it be better than a sleeve? Yes. However, based on what I've seen, I'd say the discrepancy between long term regain and maintenance with a longer CC (200 or longer) versus shorter CC (100 or less) is a bit more serious than what you seem to believe. From what ive seen, there are many more people struggling to lose all their excess weight and prevent regain than their are people struggling with malnutrition.

As far as protein is concerned, your bougie size will play a role in this as well.

If anything, standard DS (100 cm CC) has some regain due to that measurement not being short *enough*. Dr Keshishian, one of the leading DS surgeons in the world, wrote an article on the Hess method and how it's still the best option when customizing CC lengths. The majority of his patients (around 75% I believe) are given a 75 cm CC. Some even shorter!

Diligence would be required while monitoring your blood work regardless of CC length, and you'd likely have to fine-tune your vitamin regimen to your individual needs.

Granted, a 37 bmi is on the shorter end for obesity and DS surgery. At the end its your body, and you have to do what's best for you, but I figured I'd offer a perspective that swings more toward the other side of the spectrum.

Best of luck my friend.

on 7/9/22 4:07 pm

I took your advice and joined that fb group. It's amazing with all of the collective info. There is a lot of info to support both schools of thought....I still have a lot to contemplate.

on 7/9/22 12:08 pm

Had my DS about 20 years ago and my CC is 75. I wish I would have gotten 50. That's what I wanted in the first place. I have never had any deficiencies and I still have to diet to keep the weight off. I have to work hard at it. I had very little free/easy weight loss immediately after the surgery too.

I hope this works out well for all of you.

on 7/9/22 4:08 pm

Thank you... glad it's been a success for you.

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