Question:
Distal or Proximal? How did you decide? Do the surgeons decide for you?

I am scheduled for my consults on the 14th (Pacific Bariatric - Dr. Rumsey) and would like to go in with as much info as possible about types. From what I've read, I'm thinking distal is the choice for me. However, don't know -- does the surgeon determine that?? What was your experience? Thanks for the info!    — blee01 (posted on May 3, 2001)

May 3, 2001
Bobbi: This is a really good question and probably depends on the surgeon -- not only in terms of what surgery(ies) he/she offers but in terms of what he/she thinks is best for you. I think that, traditionally, the distal surgery (either an RNY or BPD/DS) was only reserved for the heaviest of us, the rationale being that one would need to lose more weight and would require a distal surgery to get it all off. However, more surgeons are open to people with lower bmis (in the 40s and up, still being morbidly obese - although I've heard of some in their mid-30's having the DS) getting the BPD/DS surgery. As far as a proximal vs distal RNY, it is wise to find out what is recommended beforehand because these surgeries have different lifestyles, etc. even though they are both 'Roux en y'. I would arm oneself with research, etc. and see what the surgeon says. I was going to leave it up to the surgeon totally (my surgeon performs the distal/proximal RNY and BPD/DS), but after researching strongly preferred the DS. I went in telling him that I strongly preferred the DS and fearing I might have to 'fight' my way for the surgery since my bmi was 45. My surgeon was totally for me choosing the DS but wanted to make sure I was aware of the nutritional aftercare needed (in terms of protein as well as vitamin supplementation). All the best,
   — Teresa N.

May 3, 2001
Hi there, congrats on you consultaion! When i went for mine my dr. choses baced upon your starting weight, i had a bmi of abot 45-47, and i had 3 feet bypassed, which he told me was mid. and i am happy with it:)i think i would go on what your doc says, they know whats best most of the time, providing yuo have a good surgen. hope this helps:)
   — sandra M.

May 3, 2001
One more vote for, "I had no choice". My surgeon told me that he by-passes 100-150cm. I had 100 cm by-passed. He also told me that the restrictive part of the RNY is the biggest contributor to the weight loss and not to be concerned about the by-passed intestine. He only does proximal, (to my knowledge), so I'm sure he meant the difference between 100-150 wouldn't make a difference.
   — Laurie L.

May 4, 2001
I wanted distal RNY, even though my BMI was only 38 because, believe it or not, I didn't eat large or high calorie meals and got fat anyway! Therefore, I chose a surgeon who does distals. Some surgeons do a variety of procedures, but most have one they prefer. You may want to consult more than one surgeon to discuss their recommendations and your options.
   — Linda B.

May 9, 2001
My surgeon does 100cm on all patients(His opinion is anything less isn't safe). However, he did say if I was an NFL linebacker,weighing 450 lbs then he would probably go more. Probably many surgeons are on an individual basis if they ask.
   — Linda M.