Is this true?

 I was looking around on OH and found a few posts regarding the Distal RNY. This poster said the Distal RNY was identical to the DS and that she used the CPT code for Distal RNY since they did not cover DS.

Is she blowing smoke or is the Distal RNY the same as DS? If anyone has some info I would greatly appreciate it! I am a bit confussed and can't find much on it at all.

well there is a pouch not a sleeve, so it is not the same just by that fact alone.

From what I understand, it's the worst of both worlds. A pouch, with no pyloric, and the massive malabsorbtion. I would NOT have it done, but that is me. Others who are smarter then I will chime in.


Ruby

She is confused. Very confused!
     I think I know who you mean. Someone who had a revision from proximal RNY to distal RNY (or maybe she now has ERNY) and was told by her surgeon that she would do "just the same" as with a DS.
     Well, distal RNY has more small intestine bypassed than the usual proximal RNY, but generally provides no further weight loss for someone who didn't do well enough with proximal RNY. So that's why some surgeons now do ERNY (E means extended, I think) for people who have failed RNY. The ERNY keeps the pouch without change, but bypassed way more small intestine, such that the patient now has a common channel similar to what we have with the DS. But neither of these is identical to a DS.
     Someone with ERNY may lose more weight, but it's a bad combination in terms of malabsorbing both the fat soluble vitamins that we malabsorb with the DS AND the B vitamins and more iron problems of the RNY. Also, any pouch problems will not be addressed, the patient still can't take NSAIDS (we can) and if they have any problems consuming protein, as many though not all people do with the pouch, those problems will be magnified now that they are also malabsorbing protein. We've seen people on this forum who had to have yet another operation to revise from ERNY to DS, not for weight loss but to address nutritional problems caused by ERNY.

Larra

Similar malabsorption, but not the same at all.

Pouch vs. sleeve w/pyloric valve
RNY will have no duodenum, DS has a small bit
RNY retains the remnant stomach in the abdominal cavity, DS does not
RNY creates a Y configuration where digestive juices from the stomach meet up with food, which is not possible in DS since the rest of the stomach is totally removed.
DS allows normal stomach churning, mixing with stomach acid, RNY does not.
Removal of stomach allows for less production of ghrelin (a hunger hormone produced in the stomach), RNY does not since the remnant is maintained.

Etc, etc.

Not the same.

If a surgeon filed for distal RNY and gives a patient a DS, well, that's his business, but it's also insurance fraud.  The DS has a CPT code and it should be used when trying to get approval.  Doing anything else is very inappropriate, IMO.  I have heard of surgeons using "creative coding" to get patients approved for the DS, and I just find that to be a really shady practice.

Yea, I just found a picture of the Distal RNY. It is not even close on the upper part! Jeesh that woman I saw post was seriously wrong wrong. There is no sleeve just the same pouch as the RNY which is a big turn off. No valve either! YUCKY! I wish someone could delete that womans post, total false info.

If you post the link to where it was, we can go address the issue with her by replying to the post.

When I get to my home computer instead of my work comp. I will get the link. :)

It's not at ALL the same. The poster committed insurance fraud.

I have a distal RNY. Original equipment i***** I have a pouch, and my intestinal arrangement is the common one for most DS today, such Dr Rabkin does.

I suspect revisions may be all different and it seriously depends on the doc who does the revision. One doc has been untruthful in his op reports many times. That's known when the victim has a 3rd surgery to fix too much malabsorption by a genuine DS doc and the true intestinal configuration is revealed.

Since this is what I have and I had it long before there was an internet in my world, I consider it the best of both worlds. My labs are fabulous, but then my doc had a pretty good launch program, even for the 90's. I've held my wt loss, as long as I keep my hands off the candy.

So, when you're looking, get the exact dimensions of the bowel arrangement. And depending on which doc,, you may be getting a "DS but with a pouch" or you may be getting a total lie.