Common channel length RNY vs DS
Adoptive mom to 3 children with Fetal Alcohol Spectrum Disorders 
No - the longer the common channel length, the more absorption of calories you have.
My common channel is 65 cm. I'm 7 years post-op. I would have been thrilled with a 55 cm common channel - of course, I started out with a BMI of 66.
Some surgeons are afraid of the power of the DS and worry about malpractice and don't trust their patients to be compliant - and in some cases that lack of trust is warranted! - so will not give a DS that is powerful enough to do the job. That - in my opinion - not only SUCKS but is the coward's way out. Not that I have a bad attitude about it or anything!
You understand, of course, that there are as many ways to fashioin an RNY as there are a DS - i.e., as many variables involved. The question for you is - is your standing RNY proximal, medial, or distal? If you're distal, than you already have a very significant level of malabsorption at play. There are many, many factors involved here. And it's very important to recognize that a conversion from a prior failed WLS to the DS is a highly complex surgery and you need a MASTER surgeon to be the person putting the pieces back together again.
Blessings,
dina
My common channel is 65 cm. I'm 7 years post-op. I would have been thrilled with a 55 cm common channel - of course, I started out with a BMI of 66.
Some surgeons are afraid of the power of the DS and worry about malpractice and don't trust their patients to be compliant - and in some cases that lack of trust is warranted! - so will not give a DS that is powerful enough to do the job. That - in my opinion - not only SUCKS but is the coward's way out. Not that I have a bad attitude about it or anything!
You understand, of course, that there are as many ways to fashioin an RNY as there are a DS - i.e., as many variables involved. The question for you is - is your standing RNY proximal, medial, or distal? If you're distal, than you already have a very significant level of malabsorption at play. There are many, many factors involved here. And it's very important to recognize that a conversion from a prior failed WLS to the DS is a highly complex surgery and you need a MASTER surgeon to be the person putting the pieces back together again.
Blessings,
dina
Open BPD/DS July 2, 2002
Revision: Lap Re-Sleeve November 10, 2008
Dr. Aniceto Baltasar, Alcoy, Spain
www.bodybybaltasar.wordpress.com
Read my DS Blog: http://livingthedslife.wordpress.com/
Revision: Lap Re-Sleeve November 10, 2008
Dr. Aniceto Baltasar, Alcoy, Spain
www.bodybybaltasar.wordpress.com
Read my DS Blog: http://livingthedslife.wordpress.com/
Ok... I found this chart online.
So, if he goes 250 that would be a good/safe distance? Right????
| Proximal RNY |
Distal RNY |
Duodenal Switch |
Scopinaro's BPD |
|
| Stomach size |
30 cc | 30 cc | 120-180 cc | 250 cc |
| Common channel |
500 cm | 100-400cm | 100 cm | 50-100 cm |
| Common channel in inches |
200 inches | 40 to 160 inches | 40 inches | 20-40 inches |
| Biliopancreatic limb length in cm (not including duodenum) |
100 cm or less than 15% of the distance between the Ligament of Trietz and the colon | For some insurance purposes, anything longer than 100 cm bypassed is considered a distal bypass | 400 cm or about 60% of the distance between the ligament of Trietz and the colon | 400 cm or about 60% of the distance between the ligament of Trietz and the colon |
So, if he goes 250 that would be a good/safe distance? Right????
Ok, first I'm not a Dser. I'm RNY, but distal, as in "measured by common channel", 100cm. My plumbing is arranged the same as a DS. But I have a pouch vs a sleeve.
That said, I've been doing what I do for a long, long time.
My summary would be that shorter (ie, closer to 100) channel helps hold the wt loss with reasonable caution. REASONABLE, not starvation!
BUT, and something that isn't noticed or is conveniently forgotten in RNY circles is that even standard RNY (most conservative) who are under supplemented will crash in the same nutrients as a DSer. The only difference is when. And if testing is being done on anyone, the problems are fixed usually with minor tweaking. Either surgery type, regardless of common channel.
Common channels of 50cm are a bit harder to fix than 100cm, but they CAN be fixed. The people, not the common channel. LOL
I have a dozen RNY's with Bariatric Beri Beri (thiamine deficiency) right now. Oh my! This is usually easily prevented with a coupla good multis (not Gummy); minimal alcohol use; minimal vomiting.
Still, that's a pretty severe price to pay if you end up in a wheel chair and you chose a conservative RNY because the pitchman said it wasn't malabsorptive and you don't need vites, right?
That said, I've been doing what I do for a long, long time.
My summary would be that shorter (ie, closer to 100) channel helps hold the wt loss with reasonable caution. REASONABLE, not starvation!
BUT, and something that isn't noticed or is conveniently forgotten in RNY circles is that even standard RNY (most conservative) who are under supplemented will crash in the same nutrients as a DSer. The only difference is when. And if testing is being done on anyone, the problems are fixed usually with minor tweaking. Either surgery type, regardless of common channel.
Common channels of 50cm are a bit harder to fix than 100cm, but they CAN be fixed. The people, not the common channel. LOL
I have a dozen RNY's with Bariatric Beri Beri (thiamine deficiency) right now. Oh my! This is usually easily prevented with a coupla good multis (not Gummy); minimal alcohol use; minimal vomiting.
Still, that's a pretty severe price to pay if you end up in a wheel chair and you chose a conservative RNY because the pitchman said it wasn't malabsorptive and you don't need vites, right?
Michelle
RNY, distal, 10/5/94
P.S. My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.
Thank you so much for all the advice/experience. I truly appreciate the input and information regarding the DS... and I truly believe it is the best surgery for me. BUT...
Unfortunately a condition I was born with will not allow me to have either the Sleeve or the DS.
Seems that I don't have a functioning pyloris because it was "disabled" when I was 4 weeks old because of pyloric stenosis: Pyloric stenosis.
So it does not matter what I think, or what I want, because my guts are already damaged from the band and the pyloromyotomy. So the RNY is the only thing I can do past the band.
Dr. Barker is the best doctor ever. He caught that and explained it to me in detail. He patiently spoke with me regarding the DS, and he listened to what I wanted done, but when he saw the pyloric stenosis surgery he put a stop to that conversation very quickly. No one would touch it because of the liver and how the pyloris heals to it and the closeness of that to the pancreas. (???)
Basically my only choices are the band or RNy because it deals with the upper part of the stomach.
Totally stinks. I don't want the RNy. I am afraid of it. But he said that it will be a more agressive bypass because of my BMI. But not quite a distal. Good Grief. Guess I will be an RNY'er whether I want to be or not.
Unfortunately a condition I was born with will not allow me to have either the Sleeve or the DS.
Seems that I don't have a functioning pyloris because it was "disabled" when I was 4 weeks old because of pyloric stenosis: Pyloric stenosis.
So it does not matter what I think, or what I want, because my guts are already damaged from the band and the pyloromyotomy. So the RNY is the only thing I can do past the band.
Dr. Barker is the best doctor ever. He caught that and explained it to me in detail. He patiently spoke with me regarding the DS, and he listened to what I wanted done, but when he saw the pyloric stenosis surgery he put a stop to that conversation very quickly. No one would touch it because of the liver and how the pyloris heals to it and the closeness of that to the pancreas. (???)
Basically my only choices are the band or RNy because it deals with the upper part of the stomach.
Totally stinks. I don't want the RNy. I am afraid of it. But he said that it will be a more agressive bypass because of my BMI. But not quite a distal. Good Grief. Guess I will be an RNY'er whether I want to be or not.
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