CC length

Discussion in 'Duodenal Switch' started by emmy, Aug 19, 2018.

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    emmy

    emmy New Member

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    Hi,

    I was wondering if the CC length in a Hess DS is an individual thing based on your anatomy?

    Should I find out what my Doctor wants to do?

    Know I'm in the best hands but was wondering what you experienced.

    For example do you wish you had more or less done?

    Also are any of the bowels removed too?

    thanks :thumbsdown:
     
  2.  
    southernlady

    southernlady Administrator Staff Member

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    Welcome emmyemmy

    Only part that is "removed" is the small intestines out of the main route of food.
     
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    Munchkin

    Munchkin Full of Fairy Dust

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    In a Hess DS, the limb lengths, including the CC is based the total length of your small bowel. The shortest one I have ever heard of is owned by a woman in Australia. Hers is 40cm. And she reached her goal weight.

    When the DS first became common most CC were between 50 and 100cm and most surgeons came to prefer the 100cm because the patients had fewer deficiencies. Some surgeons are now doing even longer CC's and the results have not been as good. Mine is 75cm and I wish it was shorter.

    The real challenge while DS shopping is finding a surgeon who does a true 2 anastomosis DS. Too many surgeons are doing hybrid procedures because they are easier. SIPS/SADI type surgeries that are experimental. Not a real standard of care DS. That is what you need to be most aware of!

    Here's the rest of the story. Measuring guts is sort of like measuring earthworms. Guts are motile. You can actually see them moving. Measuring them is a best guess scenario. I would bet money we could put the 10 best DS surgeons in a room and have them measure out the same CC on the same patient and none of the measurements would match.

    I would always go with the shortest CC I could get.
     
    Connie F. likes this.
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    emmy

    emmy New Member

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    Thank you !! Very valuable info!
    is anything other than the stomach, GB like bowe removed?
     
    Munchkin likes this.
  5.  
    Munchkin

    Munchkin Full of Fairy Dust

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    No bowel is removed. The switch part of the DS is reversible.
     
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    galaxygrrl

    galaxygrrl Well-Known Member

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    I think the CC issue is a YMMV issue. Some people really do fine with a 100 CC and others need a smaller one. Munchkin wants a shorter one. Mine is 100CM and I'm OK, though I would like to be 20 pounds smaller, but my BMI is 24, so who cares.

    More than 100 would concern me a bit thought
     
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    Dorthy Davis

    Dorthy Davis Member

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    thanks !!
     
  8.  
    hilary1617

    hilary1617 First time at the rodeo.

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    The bespoke nature makes Hess best, but I have a cookie cutter 100cm DS and am very happy with the results 6 years out. :)
     
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    Remingtonh

    Remingtonh Well-Known Member

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    You guys are talking about the difference of less than 1 foot length of bowel, out of what, 20 or 25 feet? I'd really be surprised if the CC length matters a whole lot once you're below 125-150cm or so.

    I think diet, activity level and general compliance with healthy eating is going to be far more impactful long term than 6 inches of bowel one way or the other.
     
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    DianaCox

    DianaCox Bad Cop

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    It’s not just +/- 1.5 feet of small bowel, which by the way is usually between 11-17 feet, it’s the proportions between an individual’s bowel length and the ratio in the common channel, alimentary tract, and biliopancreatic limb, as well as age, sex, health issues (e.g., diabetes), prior surgery/number and amount of prior weight loss experiences (more prior weight loss = lower metabolic rate), etc. It’s an art as well as science to determine limb lengths.
     
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    Remingtonh

    Remingtonh Well-Known Member

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    Is there any real evidence that suggests the Hess method is measurably better than the 'cookie-cutter' method?
     
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    RainCity

    RainCity Well-Known Member

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    Yes
     
  13.  
    Remingtonh

    Remingtonh Well-Known Member

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    well I'm convinced ;)

    And I mean real meaningful difference. If it's 5% or less excess weight loss difference or something, that really isn't worth arguing about.
     
  14.  
    Remingtonh

    Remingtonh Well-Known Member

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    I agree that 200 cm CC is too long.
     

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