Common channel

[CoramDeo 39]

So, when I had my first follow up, my Dr and I talked about the common channel. Mine is approx 250cm. He said that there are opposing schools of thought on this, because my weight loss may be slower, and I will need to be more diligent to stop regain. But, that I should also have little to no diarrhea issues, and less malnutrition worries. He also pointed out that if need be, this can be altered in the future. Does anyone have a CC of this kind of length, long term

[Strivingforbetter 246]

My common channel is 150 cm long, but I really wish I had gone shorter to 100 cm because those patients who had a shorter channel lost quicker and more than I did, and they started out heavier than I was. With a BMI of 40 at the time of surgery, I was worried I would get too thin. Ha! No worries there. I've regained 4 pounds since my surgery two years ago.

Edited October 4, 2019 by Strivingforbetter

[RickM 1,747]

Funny that we were just talking about this last night at our meeting with Dr. Keshishian. While 100cm has been something of the standard for ages (this is with the "traditional" BPD/DS) the common channel is more variable these days, with 150-200 being sited more often. Dr. K's practice is, after measuring the entire small bowel, dividing it up by ratios between the alimentary and biliary limbs and the common channel, with ratios being somewhat variable depending upon a number of factors including age, gender, BMI, metabolic issues, diabetic issues. So guys, and taller ones at that, will tend to get longer CC's than shorter women, particularly if they are not diabetic or have other significant metabolic problems.

If you are talking about a SIPS/SADI/ "loop DS", from what I have seen, that does tend to run a longer CC - 2-300 cm - but it is still early on with that procedure so there are a lot more variables in how different docs perform it.

With you being of "moderate" weight by WLS standards (did you ever think that you would be "moderate"?) the less extreme approach has merit; it really comes down to your inclinations, as to how much of a "bigger hammer" than a basic VSG do you, personally, need? I started out a few pounds lighter than you and lost about 50 of it on myown when my wife went through her DS, and kept that off for several years until insurance started covering the VSG. With that history, I decided that the DS was overkill for me, though maybe a moderate amount of long term malabsorption would be useful in weight maintenance (so far, so good, though more fluctuations than I would like...)

[Postop 404]

@CoramDeoMy DS was a long time ago and was 100cc. What your dr. said is basically true. Fewer possible gastro. and malabsorption issues. However, generally less and/or slower weight loss .

Edited October 5, 2019 by Postop

[Aaron2000 0]

Hi Guys,

I am at a BMI of 40 so I don’t need anything drastic but I don’t want the sleeve because of the potential regain. My surgeon said that he can do the SIPS for me with 350cm of bowel instead of 300. He said this should take away the risk of malnutrition and frequent bowel movement but still help with the regain issue. Any one here experience this or hear of this ?

[Thurscon 0]

I caught a glimpse of my doctor's notes (I'm pre-op) and they said something would be 300cm, and the common channel would be 200cm. I have a 46.6 BMI, so not 50+, but not mild obesity either.

He also said he would make the common channel longer (200) because it's less malabsorption, and because I could expect less gastro issues. I'd expressed some worry about the social consequences of being gassy and smelly, so maybe that's why. Or maybe it's the new norm for DS. Or maybe it's because SADI isn't covered by my insurance, so I have to do classic DS... but milder. Not sure

[Wellington4321 17]

Hi, I had the Sadi DS in Nov 2014 with a 40 bmi. My common channel is 300cm and I have no issues with malnutrition as long as I take Vitamins albeit less than a Hess DS patient (non-Sadi). The less is more theory has worked for me, meaning a longer common channel gave me 100% weight loss and kept it off while keeping me from being malnourished. I can eat a horse and not gain weight, although eating poorly will cause gas and bloating.

[Thurscon 0]

That's good to know. Thank you ^