Question:
Does RNY always involve a malabsorptive component?

I went to an informational session at my surgeon-to-be's office and was described a laparoscopic RNY procedure, that leaves you with a 1/2 ounce pouch (along the greater curvature of the stomach) and NO malabsortption. Is this possible? Doesnt RNY always have some malabsorption (contributing to greater and sustained weight loss). Was the nurse wrong?    — Dana D. (posted on June 22, 1999)

June 22, 1999
The VBG creates the same pouch, but does not bypass any intestines, with no malabsorption. Maybe she was describing the vertical gastric banding. The RNY has to bypass intestine. The RNY was used long before obesity surgery for regular stomach ulcer or stomach cancer operations. Maybe she was indicating that you would be having a proximal RNY which bypasses much less intestine and therefore has less malabsorption.
   — Deborah L.

June 22, 1999
She was definately describing the RNY. She just insisted that there was no malabsorption involved. It would be very similar to a VBG if there isnt any malabsorption involved. An I asked the question several times, in diffrent ways. (ie how much of what I eat will be absorbed, and how much malabsorption will there be etc.) each time she said that the weight loss is a result of "restriction" and not malabsorption. (As if malabsorption at ANY level is bad). The funny thing is that she said that post op I will be on B-12 shots (sublingual or tabs aren't recomended). I sat there thinking if there is NO malabsorption why the B-12 injections? Maybe they just bypass a very very short portion of the small intestine? I don't know if I want that..(would be too close to what a VBG is...but not really a VBG).
   — Dana D.

June 23, 1999
what was described to you was a stomach stapling VBG, Not an Roux en Y. (Roux was the name of the doctor who initiated the procedure). the Y part refers to a y-shaped "limb" that is fashioned to bypass your stomach and connect it to your small intestine (bypassing a few feet of intestine). THAT is malabsortive. RNY always includes malabsorption: that's the point!!! It comes in at least two flavors: proximal (near) and distal (far) depending on circumstances, patient's health and doctor's procedures. The longer the limb, the greater the weight loss but the greater the danger of malnutrition... it's a balancing act and requires a lot of converstation with your prospective surgeon. Good luck Susan [email protected]
   — Susan C.

June 27, 1999
YES!! She was wrong. The whole point of the by-pass is to have mal-absorption. The more intestines by-passed, the more mal-absorption there is. If you by-pas any part of the intestinal system, YOU WILL HAVE MAL-ABSORPTION to some degree.
   — [Anonymous]