What is dif between distal and proximal RNY?

I've seen this brought up before, distal and proximal and am in the beginning stages and still learning.  Are these two types of RNY or am I completely off base.  Also people have made comments about making sure you have the right amount of small intestine removed, is that something you ask your surgeon.  I don't remember that ever being discussed when my daughter had her RNY, thanks brandyII.

There is really one type of RNY, which consists of a pouch with the small intestines changed around and reconnected in a Y chape, the bottom of the Y being the common channel where food and digestive juices mix before entering the large bowel. This is a brief explaination.
Proximal refers to how much small bowle is bypassed, proximal meaning 50-100 cm of bowel bypassed. Sometimes a surgeon bypasses 100-150cm and this is sometimes referred to as a medial. Distal means anything over 150cm bypassed, and can mean as much as 400-500 cm bypassed. The more small bowel bypassed, the shorter the the bottom of the "Y" configuration is. Meaning less fats, vitamins, carbs, and other foods will be absorbed.
When a person has the traditional RNY, distal, medial, or proximal, and gets the bowel portion of the surgery revised, it is called Extended RNY, or ERNY. This means the stomach pouch isn't changed, unless the surgeon just tightens up the stoma, or the pouch, but doesn't take down the pouch and make it into another proceedure.
If one gets an ERNY, more calories are malabsorbed, and the person should lose more weight.
There are a few of us who have what is called a " true" distal, or ERNY as a first surgery, not as a revision.
I hope I didn't confuse you! Ithink some people would say to ask your surgeon to bypass as much as possible, because the malabsorption helps keep weight off later down the road.  Just know that vitamins will play a big role in good health when anybody has surgery that malabsorbs food. And the less food is absorbed the more vitamins are needed.

Hi Brandy:

They don't remove any of your small intestine they bypass it. There is an excellent description of RNY Surgery on this site. I believe it even shows you a video as to how they perform the entire procedure. Sometimes it's easier to understand if you see a visual. I know it is for me.

Go to the RNY Forum and to the right of the screen there should be a description/video of the surgery.

Good Luck....

Thanks guys,

I suppose I should read my book!  I thought when bypassed it was removed, it is confusing but I'm a visual learner of sorts so I'll check out the videos and read the book I have, WLS for Dummies, very fitting!  Anyway I appreciate your explanations.  I know I'll be back though with more questions, thanks again, brandyII.

 The bottom portion of the "Y" that LosingSally has already discussed is what everyone is referring to as the "common channel", just so you understand the lingo.   There are diagrams and videos all over the web that show the entire bypass procedure.   It's much easier to understand when you see it visually.

You may want to take a look at these two articles I found in a bariatric journal:

www.obesityhelp.com/forums/revision/3886215/Everyone-should-read-this-Revision-Procedures-for-Failed-Gastric-Bypass/

and


www.obesityhelp.com/forums/revision/3886208/Great-article-on-RNY-revisions-from-Bariatric-Journal/


I hope these help you with your decision.   If you don't understand some of the terms you can google them, or ask your doctor when you see him or her.   At least you will know the lingo and the right questions to ask, so you don't wind up disappointed when your surgery isn't what you expected, like so many on this revisions board have been.