Okay, part one:
There are a few major variations of the RNY gastric bypass, all of which vary regarding the malabsorption aspect. These variations somewhat depend on how much and what parts of the intestine the surgeon bypasses.
The variation that Dr. Callery specializes in is primarily restrictive, while malabsorption is an effect of the procedure (rather than the surgical mechanism). In contrast, duodenal switch (and some of the other bypass variations) may use malabsorption as a primary mechanism.
For example, they make the stomach incredibly small (not much larger than a golf-ball or two) - and the restriction aspect of this prevents individuals from eating too much food (hence losing weight). This is the primary mechanism of the surgery, while the parts of the intestine that they bypass also cause some malabsorption.
I guess it's more along the lines of "there's more than one way to skin a cat", and it depends on the doctor/surgeon that describes it.
I'll try to have the doc get me a better description this week.
John
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