Question:
Can a Distal be done after an RNY?

I had open RNY 3 years ago. I went from 384lbs to 206lbs. I'm now at 281lbs. Should I consider doing a Distal in addition to the surgery I had 3 years ago? And can it be done?    — Jo T. (posted on February 27, 2002)

February 27, 2002
A "distal" as you refer to it is actually a type of RNY, not a completely separate operation. Yes, you can go from proximal to distal, but I think you need to seriously look at what has caused you to regain lost weight in the last three years. Remember, this is only a tool. Good luck to you.
   — Terissa R.

February 27, 2002
Jo, I have to agree with the last poster. The first thing you would have to do is to evaluate "why" you gained the weight. "If" it's because of bad food choices, a more distal procedure would not be of benefit to you. Why? Because, although you would most likely lose weight, you would also most likely become very sick from a lack of the right foods and an overabundance of the wrong ones. I'm having problems right now with nutrition and anemia and I have been following things to the letter. If I hadn't been, I am sure that I would be much worse off by now. I think that I would have to urge you to seek counsel before going ahead with further surgery to see what has caused this weight gain. You can definately get a hold on the problems and then go forward with whatever you want to do from there. Good luck to you.
   — Barbara H.

February 27, 2002
Jo, are you having a revision because of a staple line disruption? Is that why you gained some of the wt back? If so, the surgeon will just go in and repair the disruption to restore your tiny pouch unless you request more done. Probably if you have a disruption, the bypass part will be ok once the staple line is fixed. When I had to have my staple line fixed, the intestinal part was not touched as everything was ok there. Since you did lose wt three years ago the surgery was working then. If you are having a Staple line fixed, ask your surgeon to transect the pouch from the old stomach this time so it won't ever happen again. With transection, the chances of a disruption are very very rare after the initial week or so of healing. With stapling only, the chances of a disruption at any time in the future are pretty high. Good luck to you!
   — Marilyn C.