Question:
Please explain what RNY Distal and RNY Proximal mean?
— twilight (posted on July 15, 2003)
July 15, 2003
I could be totally wrong, but I think the difference is the length of the
intestine used before the Y in the RNY surgery. But don't quote me on
this.
— Zipper R.
July 15, 2003
The first answer is correct, and I would like to add that the difference in
the placement of the cut on the small intestine makes a big difference in
how much malabsorption you of your food you will get after the surgery. As
I understand it, distal rny is usually only recommended for patients of 500
lbs or more, who may not be able to lose with smaller stomach size alone.
Proxiaml lets you absorb almost all of the nutrients from your food except
vitamin B, while distal causes more malabsorption that proximal. Hope this
helps. Lynn
— Paul R.
July 15, 2003
There is no hard and fast terms for distal versus proximal. Read the
posting from yesterday someone referred to herself as a "short
distal" with only a bypass of 100cm while most people would consider
that a proximal. And there is varying degrees at to how distal the distal
is. A true very distal distal would have a common channel of 50-150cm, the
average being 100cm. This means they have bypassed significantly more than
100 or 150 cms. But it varies from surgeon to surgeon. And to make it
more confusing some surgeons offer a "medial" which is somewhere
in the middle ground.
And you don't have to weigh 500 pounds to have a distal. One thing I have
heard is that most surgeons don't like to perform one on anyone with a BMI
of less than 50, but again that varies.
I know several people now who've had the DS (duodenal switch) which uses a
distal bypass for everyone. Some of these people have BMIs down as low at
40 - just like the RNY and do well with it.
So basically the difference is how much is bypassed. When the intestine is
hooked back up further down it means that your common channel or the area
where the food mingles with the gastric juices and it then absorbed is
shorter. The shorter the common channel the less change your body has to
absorb what you eat. It can help you keep off weight better long term but
also it is more risky for nutritional deficiencies and thus you have to
watch your labs and take your supplements religiously for life.
Definitely do a lot of research. The more you understand the surgeries
available and how it affects things long term the better you'll be able to
make an informed decision.
Good luck!
— Shelly S.
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