The Loop surgery...Vagus Nerve, and the hormone ghrelin

Hi here...Been gone for awhile. Have started to hear about the bypass surgery called "the Loop". Just wondering if they cut the vagus nerve (on the stomach) and does it release less of the hormone ghrelin like in the RNY surgery? Thanks for any info...

Most of the weight loss surgeries modify ghrelin to various degrees, though any gastrectomy tends to reduce it the most. If you are considering this surgery best to ask the doctor to what degree it does as many have variations on the same procedure. Much as no two people make a dress or quilt the same way even if it's the same pattern, no two surgeons remove or change the same amount of stomach. No two stomachs are identical, either. As for ghrelin in general, they are now discussing that surgery alters bile salts and hormones like GLP-1, and that this provides the metabolic advantages and reduced hunger rather than it being simply the lowered levels of ghrelin.

As for cutting the vagus nerve (a vagotomy), you would need to ask your surgeon. Some do and some don't. Some of the extended branches of the vagus nerve are cut during most of the surgeries though, because these are the nerves that go over the back curvy part of the stomach called the fundus. That's why we have no feelings of fullness for some time after the surgery. The removal of the stomach is what reduces ghrelin production actually; the vagus nerve itself doesn't secrete it. It communicates signals from the stomach and several organs to the brain. Much of satiety is hormone based, actually. This is a much better question for a doctor because the ghrelin-vagus link is still being studied, and they likely would have a more thorough and accurate answer.

Glad to see you caught this one Donna. You've studied all of these things in such depth.

And it's nice to have you back here; hope you are well and have just been busy.

I missed you guys. :)

Life happens as it does for all of us, and I had to focus on my mental and physical health. I should post a general update at some point. I have missed you all too!

The bypass is NOT the loop, but instead a hybrid of the DS that docs that never did the DS before are coming out of the woodwork to perform now. It has a sleeve stomach and only one anamastosis instead of two. The Loop DS/SIPS/SADI hybrids have been around for less than 10 years now, so still not a lot of data out there to determine longevity yet - but showing promise in many.

https://www.dsfacts.com/duodenal-switch-vs-sadi-sips-loop-ds .php

What concerns me is that many patients thought they were getting a real DS, the surgeon bills for DS and the op report does not describe DS, so there are issues with (some) surgeons being unscrupulous in order to get paid.

It's supposed to require less supplementation, but many are still taking the same supplements as RNY and DS patients. Bile reflux is the only complication up until recently someone came up on another board with decayed matter infection in the loop part and they were having trouble finding a surgeon to help. That was a first.