Obesity Surgery

, 18:1364 | Cite as

Influence of Jejunoileal and Common Limb Length on Weight Loss Following Roux-en-Y Gastric Bypass

  • Alexandre Lages Savassi-Rocha
  • Marco Túlio Costa Diniz
  • Paulo Roberto Savassi-Rocha
  • Jander Toledo Ferreira
  • Soraya Rodrigues de Almeida Sanches
  • Maria de Fátima Haueisen Sander Diniz
  • Henrique Gomes de Barros
  • Inara Kellen Fonseca
Research Article



Capella surgery is one of the technical variations of Roux-en-Y gastric bypass. The method includes the preparation of an alimentary (Roux) limb with a standardized length (110 cm) in order to induce deficiencies in the absorption of macronutrients and thereby contribute to weight loss. The recognized variation in jejunoileal length in humans (approximately 4 to 9 m) is not considered, although this range correlates with the wide variation in the length of the common limb.


In order to assess the influence of variations in jejunoileal and common limb lengths on weight loss, intra-operative measurements were made of these segments on 100 patients undergoing Capella surgery. Patients were followed for a period of 1 year. Statistical analysis included subdivisions of the population by gender and body mass index.


Average jejunoileal length was 671.4 ± 115.7 cm (434–990 cm). Average common limb length was 505.3 ± 113.3 cm (268–829 cm). No correlation was detected between jejunoileal length and weight loss at 6 months or 1 year following surgery. A weak negative correlation was detected between weight loss and common limb length at 1 year following surgery in male and super-obese patients.


Jejunoileal and common limb length vary widely in gastric bypass patients. To make modifications in the alimentary and/or biliopancreatic limb length, surgeons must consider the variability of the jejunoileal and common limb length.


Obesity surgery Malabsorption Gastric bypass Intestinal length 


  1. 1.
    Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142(7):547–59.PubMedGoogle Scholar
  2. 2.
    Capella RF, Capella JF, Mandac, et al. Vertical banded gastroplasty-gastric bypass: preliminary report. Obes Surg. 1991;1(4):389–95.PubMedCrossRefGoogle Scholar
  3. 3.
    Capella JF, Capella RF. The weight reduction operation of choice: vertical banded gastroplasty or gastric bypass? Am J Surg. 1996;171(1):74–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Bryant J. Observations upon the growth and length of the human intestine. Am J Med Sci. 1924;167:499–520.CrossRefGoogle Scholar
  5. 5.
    Hess DS. Limb measurements in duodenal switch. Obes Surg. 2003;13(6):966.PubMedCrossRefGoogle Scholar
  6. 6.
    Underhill BML. Intestinal length in man. Br Med J. 1955;19;2(4950):1243–6.CrossRefGoogle Scholar
  7. 7.
    White S, Brooks E, Jurikova L, et al. Long-term outcomes after gastric bypass. Obes Surg. 2005;15(2):155–63.PubMedCrossRefGoogle Scholar
  8. 8.
    Griffen WO Jr, Young VL, Stevenson CC. A prospective comparison of gastric and jejunoileal bypass procedures for morbid obesity. Ann Surg. 1977;186(4):500–7.PubMedCrossRefGoogle Scholar
  9. 9.
    Brolin RE. Long limb Roux en Y gastric bypass revisited. Surg Clin North Am. 2005;85(4):807–17.PubMedCrossRefGoogle Scholar
  10. 10.
    Bruder SJ, Freeman JB, Brazeau-Gravelle P. Lengthening the Roux–Y limb increases weight loss after gastric bypass: a preliminary report. Obes Surg. 1991;1(1):73–7.PubMedCrossRefGoogle Scholar
  11. 11.
    Choban PS, Flancbaum L. The effect of Roux limb lengths on outcome after Roux-en-Y gastric bypass: a prospective, randomized clinical trial. Obes Surg. 2002;12(4):540–5.PubMedCrossRefGoogle Scholar
  12. 12.
    Feng JJ, Gagner M, Pomp A, et al. Effect of standard vs extended Roux limb length on weight loss outcomes after laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2003;17(7):1055–60.PubMedCrossRefGoogle Scholar
  13. 13.
    Fobi MAL, Lee H, Igwe Jr D, et al. Revision of failed gastric bypass to distal Roux-en-Y gastric bypass: a review of 65 cases. Obes Surg. 2001;11(2):190–5.PubMedCrossRefGoogle Scholar
  14. 14.
    Fox SR, Oh KH, Fox K. Vertical banded gastroplasty and distal gastric bypass as primary procedures: a comparison. Obes Surg. 1996;6(5):421–5.PubMedCrossRefGoogle Scholar
  15. 15.
    Inabnet WB, Quinn T, Gagner M, et al. Laparoscopic Roux-en-Y gastric bypass in patients with BMI < 50: a prospective randomized trial comparing short and long limb lenghts. Obes Surg. 2005;15(1):51–7.PubMedCrossRefGoogle Scholar
  16. 16.
    Freeman JB, Kotlarewsky M, Phoenix C. Weight loss after extended gastric bypass. Obes Surg. 1997;7(4):337–44.PubMedCrossRefGoogle Scholar
  17. 17.
    Papadia F. Effect of standard vs extended Roux limb length on weight loss outcomes after laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2004;18(11):1683.PubMedGoogle Scholar
  18. 18.
    Diniz MFHS, Passos VMA, Diniz MTC. Gut-brain communication: how does it stand after bariatric surgery? Curr Opin Clin Nutr Metab Care. 2006;9(5):629–36.PubMedCrossRefGoogle Scholar
  19. 19.
    Rubino F, Gagner M, Gentileschi P, et al. The early effect of the Roux-en-Y gastric bypass on hormones involved in body weight regulation and glucose metabolism. Ann Surg. 2004;240(2):236–42.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • Alexandre Lages Savassi-Rocha
    • 1
    • 4
  • Marco Túlio Costa Diniz
    • 1
  • Paulo Roberto Savassi-Rocha
    • 1
  • Jander Toledo Ferreira
    • 1
  • Soraya Rodrigues de Almeida Sanches
    • 1
  • Maria de Fátima Haueisen Sander Diniz
    • 2
  • Henrique Gomes de Barros
    • 1
  • Inara Kellen Fonseca
    • 3
  1. 1.Instituto Alfa de GastroenterologiaHospital das Clínicas da Universidade Federal de Minas GeraisBelo HorizonteBrazil
  2. 2.Serviço de Endocrinologia e MetabologiaHospital das Clínicas da Universidade Federal de Minas GeraisBelo HorizonteBrazil
  3. 3.Faculdade IBMECBelo HorizonteBrazil
  4. 4.Belo HorizonteBrazil

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