Distal vs ERNY
Can anyone tell me the difference? Like how much is bypassed in a distal and how much in the ERNY? I know your common channel is 50 to 100 cm, but how much intestine do they really bypass in ERNY? Also what does common channel mean? I hear this all the time on here, but I want to be clear in my definitions. Thanks!
WHEN LIFE KNOCKS YOU DOWN TO YOUR knees, JUST REMEMBER THAT YOU ARE IN THE PERFECT POSITION TO PRAY. HW 395, RNY 4/2/07 345, Lowest Weight 248, Revision to Distal RNY 1/13/09 278,Revision to DS 10/15/10
Firstly, the normal length of your intestine is about 1000cm (10metres) from top to bottom. Food and digestive chemicals (enzymes) mix freely all along that length, and your food is broken down in stages as it travels along.
In malabsorption the idea is to create a second pathway for your insides, so that for some of the food's journey it is separated from the chemicals we produce to digest it. There is a point where these two paths join, and digestion begins. This point is called the 'common channel or CC'. The shorter the CC is, the less time the chemicals and food get to mix, and the less calores you take in from the food.
From what I've read, the normal RNY doesn't bypass much intestine because it doesn't intend to be a malabsorption surgery. So only about 50-100 cm is bypassed, leaving the rest of your tubes intact - you have a 'common channel' if you want to call it that, of 900 to 950cm.
DSers have the opposite - they have usually 900cm bypassed, and a common channel of 100cm. So the food and chemicals only get to mix for 100cm, and what isnt broken down in that time (mainly fats and protein because they are complex molecules) gets pooped out.
ERNY has similar figures to the DS - the common channel can be as small as 50cm, or as large as the surgeon prefers. Even with DS the length of CCs can vary depending on the method the surgeon uses or his/her experience of how well patients do.
Hope this helps!
In malabsorption the idea is to create a second pathway for your insides, so that for some of the food's journey it is separated from the chemicals we produce to digest it. There is a point where these two paths join, and digestion begins. This point is called the 'common channel or CC'. The shorter the CC is, the less time the chemicals and food get to mix, and the less calores you take in from the food.
From what I've read, the normal RNY doesn't bypass much intestine because it doesn't intend to be a malabsorption surgery. So only about 50-100 cm is bypassed, leaving the rest of your tubes intact - you have a 'common channel' if you want to call it that, of 900 to 950cm.
DSers have the opposite - they have usually 900cm bypassed, and a common channel of 100cm. So the food and chemicals only get to mix for 100cm, and what isnt broken down in that time (mainly fats and protein because they are complex molecules) gets pooped out.
ERNY has similar figures to the DS - the common channel can be as small as 50cm, or as large as the surgeon prefers. Even with DS the length of CCs can vary depending on the method the surgeon uses or his/her experience of how well patients do.
Hope this helps!
DS revision from failed lapband
Sal, thanks for your explanation, it was very helpful to me too. When I see my surgeon I plan to ask him about his plans for the size of my pouch plus the amount of intestine he plans to bypass. This after the 2 failed lapbands due to autoimmune disease that was diagnosed after the first two surgeries. Again, Thanks
Among those whom I like or admire, I can find no common denominator, but among those whom I love, I can; all of them make me laugh.
Thank you so much. I figured that I should know what I'm talking about when I talk to my doctor about how much he is planning to bypass. Do you by any chance know how much they bypass when they do the distal rny? I've been told that it isn't the same as erny. Thanks again for that great explanation.
WHEN LIFE KNOCKS YOU DOWN TO YOUR knees, JUST REMEMBER THAT YOU ARE IN THE PERFECT POSITION TO PRAY. HW 395, RNY 4/2/07 345, Lowest Weight 248, Revision to Distal RNY 1/13/09 278,Revision to DS 10/15/10On September 12, 2008 at 2:52 PM Pacific Time, Monique H. wrote:
Thank you so much. I figured that I should know what I'm talking about when I talk to my doctor about how much he is planning to bypass. Do you by any chance know how much they bypass when they do the distal rny? I've been told that it isn't the same as erny. Thanks again for that great explanation.You're welcome - who knew we'd have to re-do anatomy when we left school!
Distal RNY hardly bypasses anything - 40 to 100cm perhaps, which I think is why RNYers have to take some B vitamins, because that bit normally absorbs them. But it seems to be done more to make the surgery possible rather than to make you malabsorb - its just where your bits reattach rather than the surgeon trying to stop you absorbing fat.
ERNY is much more bypass - 900 to 950cm, and then the intention is to restrict the amount of calories you absorb.
Oh and if I'm wrong on the figures let me know btw - I never discussed this with my surgeon, he just gives 100cm common channels, knowing that they'll work with the tiny stomach I ended up with!
Sal
DS revision from failed lapband
I just read this again and wanted to say that I know that when you have a proximal rny they bypass it is either 100 or 150 cm of intestine and for distal they bypass even more. I just wasn't sure how much was bypassed with erny and distal if there was truly a difference between the two.
WHEN LIFE KNOCKS YOU DOWN TO YOUR knees, JUST REMEMBER THAT YOU ARE IN THE PERFECT POSITION TO PRAY. HW 395, RNY 4/2/07 345, Lowest Weight 248, Revision to Distal RNY 1/13/09 278,Revision to DS 10/15/10
mew6495
on 9/15/08 11:30 am - MI
on 9/15/08 11:30 am - MI
That is interesting on how much is bypassed. I had the understanding that for a proximal you had a 150 cm common channel or longer, for distal you had anywhere from 100 cm to 150 cm and for ERNY you had anywhere from 50 to 100 cm CC. I had Proximal RNY in 2001 and this was how it was explained to me then and recently with my research into the ERNY.... Perhaps I got it wrong. I guess then my next question would be, if I don't have more bypassed then, even though I have gained some of my weight back, I'm wondering why I haven't gained more back???? My pouch has stretched so I know it is not the restriction any longer that is helping....This whole CC business can be confusing. 
And pekin sal...love your feedback and support you give. Thanks for sharing your experiences without being judgmental about others' choices even if they choose differently for their preferred wls.
And pekin sal...love your feedback and support you give. Thanks for sharing your experiences without being judgmental about others' choices even if they choose differently for their preferred wls.
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