Proximal vs. Distal

I know that this should have come up with me before this, but for some reason, I didn't think of it. Anyway, I was reading about RNY again tonight and came across the proximal vs. distal explanations. For some reason, I thought Dr. Hart did the proximal and when I read about the distal, I thought, "boy, I'm glad Dr. Hart doesn't do that." Then, realizing that I didn't know for sure exactly how much of the small intestine he bypasses, I decided to go on to the Atlanta Bariatrics website and look. According to that, he reroutes 100-150 centimeters! Now, if I am not reading it wrong, "A Complete Guide to Obesity Surgery" (the book Dr. Hart recommends we read) put that much bypass in the distal category. And, they don't seem too fond of it - saying that this creates a greater chance of nutritional deficiencies, more frequent and softer bowel movements, possibility of embarrassing gas and stool odor and a possibility of losing too much weight. Can someone please clarify for me? Am I seeing this wrong? Does this mean I will have the distal gastric bypass instead of the proximal? Any of Dr. Hart's patients - did he ever say exactly which one he does? I don't remember him explaining this. Thanks. Marilee Surgery in 10 days!

I have heard that 75cm is what is cansidered a proximal RNY, and anything over that to be distal. I heard you could get some deficiencies if it is more. I was tols that it is really up to the Dr. They say usually that if someone has a lot of weight to lose that distal is better at losing it and keeping if off lonh term. My Dr. only does 75cm. He would not even consider anything else. Jennifur

Hi Marilee! I asked Dr. Hart about this at my first consult. I was concerned about too much of a bypass leading to nutritional deficiencies-and I have other health issues that I knew that would aggrivate. He told me he normally bypasses between 100-125 cm. He told me in my case he'd stick closer to 100 because of my other issues. He told me he doesn't believe the 25 cm makes a huge amount of difference, but he'd rather play it safe in my case. He gave me the impression that he didn't think it was a big issues, though. Best of luck to you--hope the 10 days passes quickly!!!! Michelle