Hi Gang. Can the Bypassers weigh in? I'm scheduled for a Bypass on June 29th and just had my last visit with my surgeon who told me he would be doing a 100cm bypass. Does this seem short? My concerns regarding the Bypass were the malabsorption and dumping. I know some people value these to help them stay on track but I do not so I thought the sleeve would be best. But I suffer from reflux and have since I was a kid so Bypass was recommended. I believe my concerns about Bypass are why my surgeon chose this "100 cm size". However, from my research most people do twice as much. Thoughts on the pros and cons? Would love to hear from other 100 cm Bypassers. Thanks!

I was always curious myself about the length of the bypass and why it matters?

My surgeon said he did 120cm I think the longer it is the more chance of vitamin deficiencies?

1 minute ago, MsMocie said:

Only about 10% of the bowel is bypassed in bypass surgery today. It used to be a lot more. This is also part of the reason why bypass is alot less invasive than 20 years ago.

I mini bypass about 25% of the bowel is bypassed. Qution one surgeon I meet a few weeks ago "this minibypass is just bull, it should be giga bypass"

Mine is about 175 cm.

Is there any issues or problems from such a large bypass??

I have no idea how long the intestinal part of my RNY was bypassed, and I bet most people don't. BUT...I just wanted to add that most RNY'ers don't dump (the number I see thrown around a lot is that 30% of us dump, but I don't know if there's any actual medical research to back that statistic up. But based on what I've seen here and on other internet forums the last few years, I wouldn't really doubt that statistic. Lots of us have never dumped. And for those who do, you can control it by limiting or avoiding sugar, which we should be doing ANYWAY.

also, most of the people who have malabsorption issues aren't being diligent with their vitamins. It can happen to those who ARE on top of their vitamins, but that's pretty rare. The only exception to that is iron - some people don't absorb oral iron very well and end up getting occasional infusions. Although even that is unusual - the majority of us absorb oral iron just fine.

Dumping, when it occurs, is primarily a function of rapid stomach emptying owing to loss of the pyloric valve, rather than the intestinal bypass portion of the procedure. The DS typically doesn't dump because it uses a VSG as its basis (so it preserves the pyloric valve) but it has a very aggressive malabsorption component.

I don't know what the common practices are these days on RNY limb lengths, but it is specified to some degree by the insurance billing codes which define the standards of care for the procedure. When my wife was getting her WLS years ago, the surgeon mentioned at one point that when he did an RNY (usually because the patient's insurance wouldn't cover a DS) he liked to make them as malabsorptive as possible within the limits of the CPT codes.

There is what is called a distal RNY which is much more malabsorptive than the standard proximal RNY that most get, but it is rarely done (at least in the US) as insurance rarely covers it. Within the normal proximal RNY world, there are some tradeoffs at play (when isn't there?) between amount of malabsorption within the legal limits on the long bypass side, and the threat of bile reflux is things are made too short. So, while it's a good topic to discuss with your surgeon if you are interested, I would go with their experience on this to get things right for your case.

I only dump or feel sick if I have something that's got abit of fat or sugar obviously 99% of what I eat or drink is really healthy but every so often I'll have a treat and it can make feel yuck and cause diarrhoea

Also malabsorption also refers to the fact we don't absorb all the calories or the fats in food we eat not just the vitamins.

I'm not sure what my BYPASS technical name was just that my surgeon used 120cm as a good length to be safe but still give me the effects of proper BYPASS but he chooses not to make the pouch so tiny like in the USA he said the tiny egg pouch is not that realistic..

I'm going to choose to trust and not question his decision. I just got a call saying they had a cancellation and my June 29th Surgery could be June 9th if I want it. I said yes without hesitating and now I'm freaking out a little. I know it's important to get my head in the game and I'm all the sudden 20 days short on time. EEEK!!