Question:
My surgeon only does the fobi & BPD/DS - why don't I see profiles w/fobi listed?

I love reading profiles - it really gives me a lot of hope and strength re possible surgery. But, I'm concerned that I don't see any listed as "fobi", only open RNY distal,proximal, other or ds. Are there only a limited number of choices we can enter into this database? I would like to read some that say "open RNY/fobi" - this would give me a better idea as to what I can expect. Also, what does distal or proximal mean? And what are the differences? Thanks for your help!    — Anne F. (posted on July 15, 2002)

July 15, 2002
when u fill out ur AMOS profile the surgery choices r limited. a 'fobi pouch' is the anatomical makeup of the pouch, that dr fobi mastered & has taught other surgeons. the anatomical changes made in a fobi procedure does not change the fact that is still an RNY/GP. i dont know if dr fobi does lap but 'lap or open' has nothing to do with his technique. i have a fobi pouch with the exception of one thing...my stomach was not transected & markers were not placed in the stapled off portion of my stomach, as this is my surgeon's preference. other than that my surgereon used the 'fobi' method in that he created the same size pouch, made the same anatomical changes in my intestines & attached a silastic ring to control the flow of food. proximal or distal defines how much intestine the surgeon used in the bypass & it affects the malabsorption/absorption of what we ingest, whether it be food, drink or medicines. my understanding of it is that the less absorption we have (more malabsorption) the quicker & greater the weight loss. dont be concerned. there r many 'fobi's' out there. good luck on ur journey.
   — sheryl titone

July 16, 2002
Try looking up Victoria Bowen's profile - I believe she had the Fobi pouch procedure done, and she's very open and informative about her surgery (plus, she has FANTASTIC recipes for us post-ops!) Good luck!
   — sssuzie1

July 16, 2002
HI! I have the fobi pouch. I am so happy with my results. I am almost 1 year Post op and at my ideal weight. I would like to lose another 5 to 10 lbs but if I don't thats okay. I went to Dr. Fobi himself for my surgery. He has a web site that has pictures and a question and answers page with over 100 questions that can give you some really good information. The site is www.CSTOBESITY.COM Good luck and e-mail me if you have any questions.
   — Yvonne C.

July 16, 2002
I believe the reason the Fobi procedure is not listed is because insurance company's see it as still experimental. Yes Dr. Fobi mastered this procedure, but has never come before the FDA for their approval of it. Hundreds, maybe thousands, have had this procedure. But, it will cost you out of pocket money to receive it. I live in Ga, have BCBS Blue Choice Option HMO, They approved Open RNY, I reapplied to get approval for the Fobi part of the procedure(The Fobi is an Open RNY with a few different "extras" added) and I was denied as it was deemed experimental. I can still have it, but I will have to pay my surgeon $1800.-$3200.00 out of pocket. At age 56, I feel the Open RNY will accomplish the weight loss I need. I have the money to pay for the Fobi, but if I use this tool(Open RNY) wisely, I'll have this money to have reconstructive surgery, which I know I will need. If I was 30, I'd pay extra for the Fobi, it just seems it would be better for long term weight loss maintenance. Jo-Dee Hortz
   — tinyjo

July 19, 2002
This is the response that Michelle the Vitalady gave to a similar question-----its put so well. To see Fobi profiles I had to put in a search for Fobi. You're right its frustrating. > Let's assume that we all start with 300" of (small) intestine. We don't, but we need to have a figure, so that's it. From the pix you've seen of RNY/gastric bypass, you know there is a left side, right side and tail of the Y. The "junction" of the sides is the determiner if a procedure is proximal or distal. > > The original intestine comes out of the old stomach and carries the digestive juices that are manufactured in the old stomach. This piece is called the bileo-pancreatic limb because it carries bile from the gallbladder and pancreatic juice from the pancreas. There is no food here. This is the LEFT side of the Y. This is the portion that is bypassed. > > The alimentary limb connects to the pouch and only carries food, but cannot digest or absorb. This is the RIGHT side of the Y. > > The tail of the Y is where both elements mix together and where digestion (if any) and whatever absorption will occur. This is the part that is still in use and is also referred to as the common channel. > > If the junction of the Y occurs in near proximity to the stomach, it is said to be proximal. If the junction occurs as a far distance from the stomach, it is said to be distal. That said, neither word describes any actual measurements of anything, so the meaning is in the mind of the person speaking of the procedure. What is proximal to my doctor is considered distal by another. > > Generally speaking, ALL RNY people will have to supplement at least the basic 8 elements, though in varying doses. We are all missing the stomach and its normal digestive function. > > Truly distal (with a lot bypassed, and a short common channel) people need to supplement in larger volume, but will achieve and maintain the better weight loss over time. Proximal (less bypassed, longer common channel) people still need to supplement the basics and can reach a reasonable weight, but after 2 years may have to work a little harder to maintain their goal weight.
   — blong

July 19, 2002
Oh, and I also wanted to comment on Jo-Dee's response. I had an open Fobi done 6-12-02 and my insurance paid for 90% of it. I do not know if this varies by insurance companies, but I received approvel within 1 week without any problem with minimal comorbid conditions. My Dr. trained under Dr. Fobi and only does Fobi ring procedures.
   — blong