I'm scheduled for my DS on 1/15, after a year long process. My surgeon recently told me he's limiting cc length to 150 to prevent serious malabsorption. Does that make sense to anyone ? My BMI is 50 and I don't agree with him and willing to put up a fight.

I am not sure I understand the question. Are you saying that he is limiting the CC (common channel) length to 150 cm maximum? or minimum? It seems that patients with a CC length of 80-100 cm achieved the greatest weight loss. But malabsorption (of vitamins) might be a totally separate criteria.

http://www.ncbi.nlm.nih.gov/pubmed/15862492

My surgeon does 150 and says that is a medial (vs. distal or proximal) bypass. I think the 150 cm length is actually pretty common. the way he described it to me is anything less than that causes big bowel problems and anything more is less effective for weight loss.

Sorry, I just re-read that you are DS and not RNY. Not sure if we are talking the same anatomy or not.

Interesting position. I have to assume he's had some issues with patients. I have a 100 cc. That's the standard for many surgeons. However, some do 75; some do 125 or 150. They often base it on the patient.

Edited January 2, 201511 yr by Postop

He only does 150 length. Period. He doesn't do the Hess method at all, but says it prevents too much malabsorption.

Well I'm fighting for a maximum of 125, but I'd prefer 100. I am never having another surgery

I don't blame you. I didn't want to go for a revision either. You see too many of those.

I came in w/an accordion folder that convinced them I was 'anal' enough to keep up with all the vits/minerals/protein requirements.

Great idea ! I have all my notes in a binder. I'll bring it with me. Thank you .

I had my DS procedure on May 8th of 2014 and it was at 100cm length. But honestly, I'm thinking that 150 might not be a bad idea. I'm losing weight by the ton....down 173 lbs in 8 months now, but I have had some major bowel events which could have been disastrous had I been at work. I'm talking on one occasion not making it to the toilet and the most horrific mess imaginable to clean up. The bottom line is 50 cm is only 19.65 inches of additional absorption. I had a doctor scheduled who told me at the last second he was going to give me a 195 cm CC, and I switched docs over it. But 150 cm is the high end of Dr. Hess's system, and I think it might be something that will allow for good weight loss, but with less hassles for you with Vitamin levels, bowel issues ,etc. It's a personal choice, but I almost wish I could go back in time and take a larger cc. You will still lose weight, trust me. A lot also depends on your age, comorbidities if any, etc. I'd try to find as many folks with a 150 cc as possible and see how they've done. G'luck to you in your decision.

Thanks for your input. I will consider it and speak with him to fully understand his reasoning. I am terrified of not losing.

I know that at this point all you think about is losing the most weight, in the fastest amount of time. I get that. But you will probably lose your weight in the 1st 12-18 months, and then have the rest of your life to live on this planet. Again, remember that I've been there and had a BMI of over 54. I would never try to coerce you into taking a larger CC-it's a deeply personal decision that ONLY YOU will have to live with. But I would grill that doctor on exactly what weight loss he would expect for you with a 150cm CC ( 2yrs , 5yrs , and 10yrs out), what benefits he sees for you going with the larger size, and then what ACTUAL RESULTS can he/she point to from patients who have already had a 150cm channel. This is a HUGE decision and you deserve all of the facts available to you!

Thank you!! I'm on it. I spoke with Jim for 30 minutes today and I can email him any further concerns that I have.

You are doing awesome, and I appreciate comments from the vets.

After 1 year post op and a weight loss stall I went to see my surgeon on Thursday. I asked him at what length he had made my cc. He said it was 120 cm. he said he used to put all of his patients at 75 cm but the malabsorption issues we not worth the risk. I have only been deficient in Vitamin K. I am completely different than most people who have had the surgery. I battle constipation everyday and have to drink Miralax. I do not have loose stools or diarrhea. My surgeon seems shocked that I have constipation issues and has ordered a stool analysis to check fat content. I am curious to see the results.

That is different than most DSers I know. Have you tried magnesium or coconut oil for the constipation issues? Do you eat a lot of fat?

After 1 year post op and a weight loss stall I went to see my surgeon on Thursday. I asked him at what length he had made my cc. He said it was 120 cm. he said he used to put all of his patients at 75 cm but the malabsorption issues we not worth the risk. I have only been deficient in Vitamin K. I am completely different than most people who have had the surgery. I battle constipation everyday and have to drink Miralax. I do not have loose stools or diarrhea. My surgeon seems shocked that I have constipation issues and has ordered a stool analysis to check fat content. I am curious to see the results.