Question:
Proximal VS Distal RNY?

What is the difference between a "Proximal" and a "Distal" RNY? Which one is better for an Open RNY?    — Kay F. (posted on February 19, 2003)

February 19, 2003
Generally speaking, a proximal RNY is when the surgeon bypasses less than 150cm of small intestine. A distal RNY is over 150cm. The choice is usually made by the surgeon based on your BMI and amount of weight you need to lose. With a distal RNY, the malabsorption is greater and the chance of malabsorption problems are greater too, so if a proximal can be done, its safer for the wls patient down the road. Some surgeons ONLY do one type and some insurance companies may only approve one type too, so keep those factors in mind as well. <p> I had a distal RNY - whereas my surgeon bypassed 200cm. I'm happy with that because my BMI at the time of surgery was 81. Good luck to you!!
   — thumpiez

February 19, 2003
I don't know which is "better" but I had the Proximal. All the benefits of a little tummy & I don't malabsorb nearly as much as the Distal. Which MEANS, that I don't have to take loads of vitamins everyday! Just a multi, some calcium & iron! It's really up to the doctor you choose. I think. Good luck!
   — LionGirl2k

February 20, 2003
A proximal RNY bypasses less intestine than a Distal RNY. The more aggressive Distal RNY results in more malabsorption. I'm sure you can find the details in the Library. My doctor would only do the proximal RNY for me. I'm very pleased, and I'm at a normal BMI one year post-op.
   — Kathy J.

February 22, 2003
Don't decide based on the terms they use, find out HOW MUCH they bypass. A proximal may vary from only bypassing a few inches up to a great deal more. I've heard of one doc in my neighboring state who only bypasses a couple of inches. Why bother if you aren't going to have enough bypassed to get you at goal, let alone keep you at goal. And its true, lots of docs only do 1 standard bypass, not fitting it to their various clients. Besides starting weight as consideration you may want to keep in mind that after your initial weight loss, your body will attempt to "fix" itself / return to normal. Your body will actually thicken the intestinal walls to increase absorption. So as time goes by the absorption rate increases as your body adapts, thus making staying at goal more difficult, especially if you've had only a minimal amount bypassed.
   — Shelly S.