Distal vs proxmital lap rny? - ThinnerTimes

gwbp · 02-15-2007, 04:30 PM

hi, im new.
i have a question about long term weight loss
Distal is more malabsorption ( less absorbed b in)
and did/do you get to choose?
I want all the help I can get!
Thanks

Blueyz · 02-15-2007, 06:00 PM

I didn't get to choose with Dr C. I believe he does the less malabsorptive one.

Dyann · 02-15-2007, 09:02 PM

I don't know about Dr. Callery, but the more distal bypass is used with much higher BMI's and super morbid obese. Each doctor has their own cutoffs and length of bypass

Duckie · 02-15-2007, 09:03 PM

I have no idea. Didn't know there were two types.

Bella · 02-16-2007, 03:04 AM

A friend of mine got the Duodenal or the 'distal'.

It indeed has MUCH more malabsorption than the RNY.

It is for people with a very high BMI - but my doctor says he never performs this surgery as it is much too extreme. One of the drawbacks is that people have a hard time stopping the weight loss.

Typically, for persons with a BMI less than 50 they make a roux limb of 120cm, for those greater than 50, a roux limb of 150 cm. Generally, a LONG limb or distal bypass refers to a roux limb greater than 150cm in length.

My friend went from a size 26 to a 2 .... in 2 years and is still losing weight. Yes, she eats everything but is still losing and is worried.

I recommend the 'gold standard' in wls which is regular RNY or the 'proxmital'.

See these links:
http://www.duodenalswitch.com/proced...s_vs__rny.html
http://www.obesityhelp.com/forums/DS/

There's tons of info. on the net - justy goggle these terms.

so_gorjess · 02-16-2007, 05:23 AM

I was aware of the two types, I even remember my surgeon mentioning something about them but I don't remember what it was that he said lol. I don't know which one I got but considering the fact that I was classified as one of his "smaller" patients, I guess I got whichever one "smaller"(ha! That's was a laugh!) patients get done...the proximal(

)?...

Duckie · 02-16-2007, 07:32 AM

proximal

Debz · 02-16-2007, 07:44 AM

I'm pre-op and still doing research. From everything I've read, there is a small advantage percentage wise (in terms of total weight lost) by doing a distal, but more unpleasant side effects from that procedure. Found this at http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

The aim of this study was to determine whether longer limb length improved results of gastric bypass in patients who were morbidly obese (body mass index <50 kg/m(2)) or superobese (body mass index >50 kg/m(2). A total of 242 patients were followed for a mean of 5.5 years. The standard operation was a Roux-en-Y gastric bypass with a 40 cm Roux limb and a 10 cm afferent limb. The long-limb operation had a 100 cm Roux limb and a 100 cm afferent limb. Morbidly obese patients did not benefit from a long-limb bypass. The final body mass index was 28.6 +/- 4.7 kg/m(2) in the short-limb group and 28.5 +/- 3.8 kg/m(2) in the long-limb group. The superobese patients did benefit from a long-limb bypass. Final body mass index was 35.8 +/- 6.7 kg/m(2) in the short-limb patients and 32.7 +/- 5.1 in the long-limb patients (P = 0.049). A subgroup of 20 patients, all of whom had a body mass index greater than 60 kg/m(2), benefited the most from long-limb bypass. No macronutritional side effects unique to the long-limb bypass were encountered.

LisaBoston · 02-19-2007, 01:45 PM

I had proximal 100cm bypass. My doctor only does the proximal as his patients have a BMI in his range...he doesn't take on lightweights or super obese. I asked for 120-140cm, but he wouldn't do it. A lot more malabsorbtion with the distal.

I don't know too many that had the distal. There are a few on the obesityhelp board that had the distal...you could check there.

Gina · 02-19-2007, 04:28 PM

I had a 150 cm bypass. I asked my dr about this and he said that even that isnt really enough to call it a distol. He said the most patients get 100, but I had a bmi of 60! He said a true distal is like 200 and he doesnt do them, and he said that they really arent done.

Hope this helps because I was curious about this a while back and asked about it too.