Question:
Proximal vs. Distal

I'm wondering what the qualifications are for proximal vs distal? I've heard (& read) the pros and cons for both. But how does the surgon decide which one he'll do for me? I won't see my surgon for a few weeks and I'd just like some feedback to go in with questions. Are height,weight,health or all of the above factors? Or is it strickly the surgeons discreation? Anyone have any thoughts? Thanks! Erin    — Erin P. (posted on March 15, 2004)

March 15, 2004
My two docs offer you the choice and you discuss it together. Many docs offer one size fits all, or 2 sizes fit all. You are the consumer, so you can shop for the doc who does the procedure you think you want, or who will at least take your concerns into the equation. We are not one size fits all people. Just as my very distal procedure is way too radical for some, a very proximal procedure would not have worked for me. And back in the dark ages, there WAS no Eric and AMOS! LOL! It was just a shot in the dark and I got lucky.
   — vitalady

March 15, 2004
I had open rny, pre-op wt 400 lbs. 15 months ago. with no complications. I have loss 194 lbs so far, My surgeon explained my options. he does both. but because of my medical issues, one because of my high risk wt, and because of my many scar tissue and adhesives from old operations. so I didn't have a choice.
   — B4real

March 15, 2004
I had open rny, pre-op wt 400 lbs. 15 months ago. with no complications. I have loss 194 lbs so far, My surgeon explained my options. he does both. but because of my medical issues, one because of my high risk wt, and because of my many scar tissue and adhesives from old operations. so I didn't have a choice.***400lbs/206***-194 lbs***open rny***goal wt 160-150 lbs***
   — B4real

March 17, 2004
For most surgeons, it depends on how much weight you need to lose, with those having less to lose having the least bypassed. However, that said, I know some docs that just bypass the same amount for all patients (like mine). And still other docs who don't bypass much on any of their patients as they believe the size of the pouch and the small amounts eaten post-op are more important than the risks of bypassing too much and having future malabsorption issues. I personally would prefer to have less bypassed. I have seen post-ops with just 75 cm bypassed lose 130 or more pounds and successfully keep it off. The more bypassed, like the distals, the more careful they must be to supplement or run the risk of nutritional deficiencies.
   — Cindy R.

March 17, 2004
For most surgeons, it depends on how much weight you need to lose, with those having less to lose having the least bypassed. However, that said, I know some docs that just bypass the same amount for all patients (like mine). And still other docs who don't bypass much on any of their patients as they believe the size of the pouch and the small amounts eaten post-op are more important than the risks of bypassing too much and having future malabsorption issues. I personally would prefer to have less bypassed. I have seen post-ops with just 75 cm bypassed lose 130 or more pounds and successfully keep it off. The more bypassed, like the distals, the more careful they must be to supplement or run the risk of nutritional deficiencies.
   — Cindy R.

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