Transecting, Proximal, etc.?????

Okay everyone, I need some help. I've read a few books and tons of info on the internet but these are somethings I still just do not feel like I understand completely. I want to know what I'm talking about before I actually have a consult so hopefully someone can help me out. I'm confused when it comes to transecting. I read that some docs transect and some don't. Although I've read about it I still don't understand it. Wow, am I a moron or what? And also if you could help me out on the proximal and is it distal(sp?), I know basically what it has to do with but that's about it. I guess I just want to know why a doctore would chose to do the proximal or the distal, and if one is better and why. Also the same with transecting. Thanks anyone who can help me out!

OK, here it goes. Proximal is when they bypass approx 120 cm or less. Medial around 120-150cm, distal 150 cm or more. With a distal, since you are bypassing more intestine, there is less absorption. Disadvantage is you need to be diligent in taking vitamins and protein supps forever, advantage, better wt loss maybe. Distals also tend to have looser stools. Proximals, some say, don't lose as well without the added malabsorption. Now, transecting. Information that I have obtained, say that transecting is the way to go. Because, you don't get SLD (staple line disruption) as easily as not transecting. Also, what can happen is that a fistual can form between old and new stomach pouch and cause problems such as wt regain. I was NOT transected and asked that I be done, but my surgeon didn't want to. I was by passed 125 cms though. My surgeon is Dr. Coster in Grinnell and he has two other partners, Dr. Eibes and Dr. Schwartz that do RNY also. I do know that Sundberg transects. Now, as far as other surgeons, Hardy, the Grinnel surgeons, do not do lap, they don't believe in it and feel you can run into more problems because of lack of visibility. The others that you mentioned do do lap.