Question:
Common channel

I really dont understand when I read something about a commen channel. All I know is that my surgeon said that he bypassed 150cm of intestines. Is this considered distal? and if yes is it distal enough to be same malabsorbtion as DS?    — Carrie W. (posted on April 26, 2004)

April 26, 2004
Let an RNY post-op try and explain this. If I'm wrong DS people, please feel free to correct me. <p>Usually an RNY bypass is measured from the top down. The small intestine is cut usually around 6"-12" down from the stomach and then reconnected further down the small intestine. A 150cm bypass means that 5' of your small intestine is bypassed, or non-functioning as far as absorption. Some docs refer to this as a distal, some as a medial (medium length). My surgeon doesn't use those terms but uses the numbers so we are clear what is being done. <p>In a DS the measurement is taken from the bottom up. The small intestine is again cut approx 12" (might be more as I am not totally sure with a DS) from the bottom of the stomach and then it is reconnected to the remainder of the small intestine way at the end. Usually 24"-48" from the end. The portion of the small intestine, after where it is connected into, is called a common channel. It refers to the amount of small intestine a DS has available to do absorption in. Therefore they have major malabsorption because there is such a short length of small intestine to do the work. In an RNY you would typically end up with about a 15' common channel, assuming you have 20' of small intestine. The actual length of a persons small intestine varies and is usually proportional to your height. <p>So in answer to your question, is your 150cm RNY bypass the same malabsorption as a DS, the answer is clearly no. A DS has about a 16' bypass, again assuming a 20' small intestine and a 4' common channel. That said, a 150cm bypass should be fine for most RNY's. My surgeon does a 150 cm bypass on the SMO and usually a 100 cm bypass on people who have 100-150 lbs to lose, assuming that does not push them into the SMO category.
   — zoedogcbr

April 26, 2004
To add to what Chris said, a very distal RNY (like mine) is measured from the bottom up (common channel). Although the pluming arrangment is the same, the longer part and shorts parts of the intestine are basically reversed. I have a lot bypassed, very little left in use. (none went in the trash). MOST docs use them same measurement for the loop that goes from the pouch to the junction. As to whether your 150cm bypassed is like my 100cm common channel or a DS with the same or less? No. For example, we should ALL take lots of calcium as that problem does not seem to be surgery specific. But you would not need as much iron as a DS or me. But more than someone with 100cm or less bypassed. Our B12 needs would be the same,ultimately, since that is dependent on the way it's hadnled vs the amount of intestine, either in use or not. Or did I make it worse?
   — vitalady