Question:
Distal or Medial RNY?

I am preparing for rny surgery, and initially was sure I wanted a distal RNY, which my surgeon recommends. However, in reading various comments on this site and others, I am reconsidering going medial instead. Can anyone give me insight as to the advantages and disadvantages of both types of RNY surgery? Thanks a bunch!    — [Deactivated Member] (posted on December 28, 2002)

December 28, 2002
Hi, my doc says there is no such thing as a medial. he says it is just a term that the misinformed use. There is only distal and proximal. It is my understanding that if you have over a hundred pounds to use, they usually do the distal. More of your intestine is bypassed and the malabsorption is greater. Some people on here say you lose better with distal, Others say there is no difference. I have right at 100 pounds to lose and I will be having a proximal. I hope it works. I have also heard of some having the proximal and then having a revision to the distal. If I were you, I would take my docs recommendation. Good luck.
   — Delores S.

December 28, 2002
Hi! My Dr. doesn't really recommend distal RNY"s because of some bowel complications that "may" happen....ie loose bowels and diahria. Also there is a greater chance of malabsorption of critical vitamins and minerals but I believe that it depends on the surgeon. I myself had a median and am doing great! I have lost 109lbs in just under 9months. I only have 17 more to lose to meet my surgeons goal for me. ( 32 more to meet my goal for myself.) I think that the Dr. usually determines how much to bypass by what your BMI is and how much you have to lose. My BMI started at 51 so it was pretty high. That's why she did a median (or long-limbed) on me. Good luck and God Bless!
   — Leah H.

December 28, 2002
Hi there. I know how confusing all of this is. There is Distal and Proximal. I had the distal because that is what my doctor recommended. I am doing great. 7 weeks post op and no nausea. My doc also says that with distal there is rarely any problems with dumping from sugar. Best to you
   — debbie11092002

December 28, 2002
I am a very distal patient of Dr Oh's. I'm doing fine. HOwever, I don't believe that he does them AS distally today as they did ages ago. A few more inches of common channel will help maintain your nutrition levels, yes. It could cost you a few lbs over the long term. Or not. It's up to you to weigh those few more vitamins, another protein shake a day. Is it worth it for a few more missing lbs? To me, it is. But it's not for everyone.
   — vitalady

December 29, 2002
Distal, proximal and medial all refer to the length of intenstine bypassed. The more bypassed, the more malabsorbtion takes place, which means more weight loss but also means more vitamins/supplements required to keep all your levels balanced and keep you healthy. Usually those with lots of weight to lose, like over 200 pounds get the distal and those with 100 to lose or so, get the proximal. I've heard that anything over 150 centimeters bypassed is a distal. So, I would imagine that just below that would be a medial. I had a proximal and had 110 centimeters bypassed. Each surgeon bypasses different amounts so talk to your surgeon. The advantage of proximal is that your body is absorbing more nutrients, hence, less supplementing. Disadvantage-not as much weight loss, but like I said, most who get the proximal don't need to lose as much as those who go distal.
   — Cindy R.