Question:
What is the difference? proximal ... distal

What is a proximal RNY and what is a distal RNY and how do I know which I am?    — csanchez1111 (posted on May 3, 2005)

May 3, 2005
Hi Cheryl, I was told that proximal is 60 to 130 cm and distal is over 130 cm. Proximal is the most common RNY and the least problematic I am told. Distal is now done in patients that surpass super morbid obesity. Years ago it was the only way to go. Hope this helps.
   — patgels

May 3, 2005
I have been told anything below 150 cm is proximal anything above 150 is distal. I was bypassed 150.
   — TheresaC

May 4, 2005
The small size of the new gastric pouch acts as a restrictive mechanism. The bypass of the stomach, duodenum, and varying amounts of the jejunum produces selective malabsorption. The more of the jejunum that remains in the common channel, the less malabsorption. If the remaining jejunum is 101"+ (255 cm+) in length, it is referred to as being a proximal RNY. A remaining jejunum length of 61" to 100" (153 to 254 cm) is a medial RNY. A remaining jejunum length of 40" to 60" (101 to 152 cm) is a distal RNY. The smaller jejunum reduces the amount of food that can be absorbed by the body. It also reduces the absorption of needed vitamins and minerals. With the Digestive Secretion tract increasing and the other decreasing. This increases the malabsorption brought about by the operation. Patients with a medial or distal procedure should take a greater amount of vitamin and mineral supplements than the proximal patient.
   — John K.

May 4, 2005
If you are lap, you are in the proximal family, tho there are variations within it. I am measured by common channel, and within that arena, there are stil variations. So, that's not much help. I'm measured at the common channel length, so distal by anyone's standards.
   — vitalady

May 4, 2005
The only way you will know if your surgeon performed a proximal or distal gastric bypass is for you to ask your surgeon. It will be documented in his operative report. It seems a lot of insurance companies will only cover the proximal version.
   — Kara J.