Distal RNY (ERNY) article
This is a very good explanation on the ERNY with drawings done by Dr. Keshishian
I cannot get the article to copy & paste, sorry. Please click the link:
http://www.dssurgery.com/newsletters/duodenal-switch-and-distal-gastric-bypass.php
RNY 2/26/2002 DS 12/29/2011
HW 317 SW 263 BMI 45.1
SW 298 CW 192 BMI 32.9~60% EWL
LW 151 in 2003
TT 4/9/2003
Normal BMI 24.8 is my GOAL!!!
GBP (RNY) 2/26/02 298 lbs, TT 4/9/03 151 lbs, DS 12/29/11
HW 317 SW 263 BMI 45.1/CW 192 BMI 32.9/GW 145 ~ Normal BMI 24.8
**Revision Journey started 3/2009 Approved 12/12/11**
on 6/10/12 2:29 am - WA
As for the common channel.... as far as I know, it is the surgeon who will along with the patient discuss this part. It does vary greatly!!!
And the vitamins.......... I will post a new topic for better discussion on the ERNY vitamin subject.
Just keep doing the research!!!! You are doing GREAT!!!
RNY 2/26/2002 DS 12/29/2011
HW 317 SW 263 BMI 45.1
SW 298 CW 192 BMI 32.9~60% EWL
LW 151 in 2003
TT 4/9/2003
Normal BMI 24.8 is my GOAL!!!
GBP (RNY) 2/26/02 298 lbs, TT 4/9/03 151 lbs, DS 12/29/11
HW 317 SW 263 BMI 45.1/CW 192 BMI 32.9/GW 145 ~ Normal BMI 24.8
**Revision Journey started 3/2009 Approved 12/12/11**
I borrowed this from a reply on Proboards:
I'm going to quote Dr Roslin's opinion on the distal gastric bypass (ERNY) below. I took it from his Keynote address here earlier this week:
"I think the best answer that I can give to this question is that those that don’t know history are doomed to repeat it. In order to have a distal intestinal bypass, a common channel of 100CM, or 150CM, or a common channel less, then for most patients you have to preserve either the fundus of the stomach or the pylorus. Preserving the stomach is done in the Scopinaro procedure, where the volume of the stomach is about 200-300cc. Dr Scopinaro has trained a lot of Italian surgeons, and actually that was the operation that was used in the most recent trial in the New England journal. All those patients had open Scopinaro procedures, and he does a 100CM common channel and a 200cm alimentary limb. So, the point is in order to tolerate a distal bypass you either have to preserve the fundus of the stomach, or the pylorus. The pylorus is called the gatekeeper.
If you do not have one of those two structures, then what is going to happen is you are going to have a rapid emptying system and basically uncontrollable diarrhea in a subgroup of patients. Obviously there is individuality and certain people can tolerate that. So when people try to do these procedures, the actual risk of protein malnutrition is above 20%. I have not had to, in my DS practice, move anybody more proximal. Occasionally there have been people that have had other ailments like pseudo membranous colitis, and have had diarrhea where I’ve had to institute therapy and then once they got over their acute illness they were able to restore their protein levels. That would be a huge concern if you move standard gastric bypass that’s based on the lesser curvature of the stomach and hasn’t preserved the fundus, if you take it and you move it distally, then you are going to have a 1 out of 5 chance of having protein malnutrition.
So this is a very easy operation, but a very, very, very poor choice and demonstrates a lack of understanding of the sophisticated physiology of the gastrointestinal tract. Again, long term, I would wager to guess that over years the majority of patients that this is done to would have to be reversed, especially if they had another medical problem. And I’ve seen a number of these patients from Brooklyn where they needed reversal 5, 7, or 10 years after it was done, because they couldn’t overcome other medical issues. So I would not recommend this as an approach."
Read more: http://weightlosssurgery.proboards.com/index.cgi?action=disp lay&board=discussion&thread=3219&page=1#ixzz1xPzjAHBG
RNY 2/26/2002 DS 12/29/2011
HW 317 SW 263 BMI 45.1
SW 298 CW 192 BMI 32.9~60% EWL
LW 151 in 2003
TT 4/9/2003
Normal BMI 24.8 is my GOAL!!!
GBP (RNY) 2/26/02 298 lbs, TT 4/9/03 151 lbs, DS 12/29/11
HW 317 SW 263 BMI 45.1/CW 192 BMI 32.9/GW 145 ~ Normal BMI 24.8
**Revision Journey started 3/2009 Approved 12/12/11**
