Question:
What is the difference in Distal or Proixmal?

Some people say that they had a Rny Distal or Rny Proixmal I don't know what the difference is or what I will be having, or know if I should know, or if it matters. Dumb question?    — Diane S. (posted on September 30, 2003)

September 30, 2003
Proximal is a medical term that means towards the beginning. Distal is a medical term meaning towards the end. So, for a proximal RNY digestive juices are diverted only to the beginning of the intestine where distal RNY the digestive juices are diverted toward the end of the intestine so that there's more malabsorption because digestive juices and food do not mix until the end of your intestine. You might ask why do a distal RNY and it should mainly be reserved for patients who have a BMI greater than 50 or are so-called "super morbidly obese".
   — Dave H.

September 30, 2003
I do think it matters. I suggest asking the surgeon what length of intestine he is planning to bypass (since proximal and distal are somewhat subjective). A distal bypass may possibly produce greater weight loss (particularly for the super-morbidly obese), but the trade-off is a greater risk of nutritional problems. So if you have a distal bypass, you need to be especially compliant with taking supplements. Good luck to you.
   — K M.

October 1, 2003
Ask your doctor what his definition is. Most RNY surgeon's who use the term "distal" do a 150cm bypass measured from the top, which really is no where near the end of the small intestine, like a DS is. A proximal is typically around 75-100cm's bypassed measuring from the top. <p>If the surgery is a TRUE distal then normally it is referred to as the common channel - the amount of small intestine that can do absorption. This is measured from the bottom of the small intestine from the Illeum (sp?) up. This normally is done with any RNY. It is very uncommon to have it done with an RNY, although there are some out there. it is very risky because you are having approx. 15'-18' (using averages here) bypassed and with a small RNY pouch you will never be able to get in enough food to stay healthy. It will be mandatory that you use numerous protein drinks in a day for the rest of your life in addition to food. If you want a bypass that long then I vote for the DS as that surgery is designed to work well with the long bypass or short common channel. <p>Most RNY surgeries are only bypassing about 25% of your small intestine, even when they call it distal. My surgeon doesn't use terms like that but just flat out tells us how much he will bypass based on our BMI etc. For the SMO it is 150cm. For all others it's usually 100cm. Like anything there can be exceptions to these #'s. FYI, most insurances will not cover a DS or a long limb (2'-4' common channel) RNY. Just have your surgeon explain what he is doing and why he is choosing that much of a bypass - short or long. You MUST clearly understand what he is doing and what it means to you long term!
   — zoedogcbr