Question:
I had RNY distal 6 weeks ago and know I can never eat sugar.

but I just spoke to a person who had distal duodenal swith by Dr Rabkin about 1 1/2 years ago. She has lost all her weight is maintaining it and eats sweets all day long. She has never been sick. Why can she eat sweets with this type of surgery. I thought distal was distal no matter what type of surgery you had.    — [Anonymous] (posted on November 4, 1999)

November 4, 1999
I hope I can explain this correctly, any fellow DS'rs please help me out with my "lingo" please!! With the Duodenal Switch (DS) procedure, there is no dumping. They remove a portion of your stomach horizontally (is that up and down I always forget!!! well I mean up and down!) and leave the pyloric valve in tact, which allows a natural progression of food into your intestines (ie., the intestine is not removed and attached to the bottom of the pouch as with the RNY it stays attached to the bottom of the stomach naturally). Distal and Proximal refer to the common channel length of the intestines only. Hence the major difference is whether it was distal DS or distal RNY. I hope my explanation makes some sort of sense. If you have any questions, please see the DS site www.duodenalswitch.com, there are explanations much better than mine comparing the two surgeries. I hope this helps.
   — Christina D.

November 4, 1999
The difference between RNY and Duodenal Switch is not in the intestinal reconfiguration. Distal is Distal. But the big difference is what is done to your stomach. In the RNY the top part of the stomach is separated and the rest of the stomach is set aside. A surgical opening is created in the pouch and intestine is connected to the pouch so food leaves the pouch unpredictably which can lead to dumping as the food just falls into the new intestine. The duodenal switch removes about three quarters of the stomach to create a very small capacity BUT the natural progression of food from the stomach through the pyloric sphincter and into the duodenum is intact. The intestine is therefore allowed the normal digestive course until it passes into the duodenum. The intact pyloric sphincter regulates food passage and this is the key to avoid dumping, food getting stuck in the pouch, pouch scarring up or closing necessitating endoscopy, etc. You can get a lot of information on duodenalswitch.com
   — Fran B.