Hilary - it is so nice to have come accross this thread and most importantly your positive take or outlook on the loop procedure. My doctor in SLC (Cottam) has done the Loop and likes it. He is not insistant one way or the other but I like you have liked what I'm finding so far. Although studies are only 3 and 5 years out the people seem to be loosing the weight quite well. You sound like you have a medical background of sorts....can you think of any BAD side effects doing the Loop compared to the DS? It seems if there were horrible negative side effects that those would have been reported in a 3-5 year time frame. While I do not want to ever have to have another follow-up surgery is does sound like a revision can be done to the original DS later......is this correct? My concern, or the reason I even mention some later revision if need be is my addiction to carbs and well just overeating in general that has put me here in the first place.....My mind keeps circling back to the thought that maybe I NEED the DS? ....and then I circle back again and think won't a Loop do? Seriously....I may drive myself to nuts before the 21st and then they can just lock me up and I won't have to actually make a decision!
I will have a follow-up question time with my Dr. but I wondered (if you know medically speaking) if having the Loop has any potential for long term problems in digestion. Does routing the small bowel differently from the DS cause any concern for what it does differently long term? Does my question even make sense LOL ....
I have tried to study the 3 different diagrams and video's on RNY, DS and LOOP. But I just don't fully grasp the implications of each. Does the Loop in your opinion offer more malabsorption than the RNY?
Hello!
First, please know I have NO MEDICAL EXPERIENCE or QUALIFICATIONS. I've been a patient a lot. That's about it. I had the DS, which I view as one of the top 10 decisions of my life.
My understanding is that there is a range of malabsorption with RNY, in which an ERNY can have a malabsorption profile similar to the DS.
In terms of your routing question, I don't know that the long term impact of bile running directly across the pyloric valve is known. This is a Loop-only construct which is not part of the normal anatomy. I'd venture to guess there are other unknowns which could potentially surface later as positives or negatives- how our bodies adapt long term to the surgery (villi length) to become more efficient food processors and/or maybe even differences in hormonal effects/benefits (thinking diabetes resolution) and nutritional needs.
The big unknown, in my mind, is long term weight loss maintenance.
In terms of WLS, my recommendations to a family member or friend would be to AVOID AT ALL COSTS any non-pyloric preserving procedure (e.g. RNY) or any procedure involving the insertion of a foreign object (e.g. band). To a loved one, at this time I would be comfortable recommending either a VSG or full, traditional DS.
That said, my view on the SADI-Loop is conservatively optimistic for those who are
willing pioneers who are knowledgeable and desire to accept the risk-reward tradeoff of undergoing a new procedure -- but
only when performed by an experienced,
vetted DS surgeon upon a
fully informed patient, as part of a
proper clinical trial, with full consent of the payors / insurance company.
The main question is what procedure would benefit *you*, the patient, most? Are you eager to explore uncharted waters for the greater good? What is your risk tolerance? What are the trade-offs for you?
