Comments on: Distal? Types of surgeries??? http://www.obesity-surgery.wordpress-by.org/2004/01/30/distal-types-of-surgeries/ About types of surgeries available, dietary, family, work, emotional.. Thu, 16 Oct 2008 00:24:18 +0000 http://wordpress.org/?v=2.2.1 By: Rickey Nichols http://www.obesity-surgery.wordpress-by.org/2004/01/30/distal-types-of-surgeries/#comment-1140 Rickey Nichols Mon, 02 Feb 2004 18:03:19 +0000 http://www.obesity-surgery.wordpress-by.org/2004/01/30/distal-types-of-surgeries/#comment-1140 I know that the NIH is behind however they do certify RNY as gold standard. I could say it is platinum too and it wouldn't mean too much though. I am not trying to be cruel or mean. But I think everyone who is satisfied with their surgery would rate theirs the best. It is an individual thing. However, I do hope that the NIH does eventually -- SOON -- take a look at all the new procedures out there and release another consensus statement. It would be nice. Denise Rasley mailto:drasley@... BTC, Columbus, 10/7/98 Lost over 90% of excess and maintaining Gained a beautiful daughter on 8/9/00 I know that the NIH is behind however they do certify RNY as gold standard.
I could say it is platinum too and it wouldn’t mean too much though. I am
not trying to be cruel or mean. But I think everyone who is satisfied with
their surgery would rate theirs the best. It is an individual thing.
However, I do hope that the NIH does eventually — SOON — take a look at
all the new procedures out there and release another consensus statement. It
would be nice.
Denise Rasley
mailto:drasley@…
BTC, Columbus, 10/7/98
Lost over 90% of excess and maintaining
Gained a beautiful daughter on 8/9/00

]]> By: Tanisha Carletta http://www.obesity-surgery.wordpress-by.org/2004/01/30/distal-types-of-surgeries/#comment-1138 Tanisha Carletta Mon, 02 Feb 2004 12:42:12 +0000 http://www.obesity-surgery.wordpress-by.org/2004/01/30/distal-types-of-surgeries/#comment-1138 The patients and doctors all call it the platinum and as soon as the NIH is updated the gold standard will change. The NIH is nearly 10 yrs behind right now. Dont you find it rather curious that medicare, being a government agency that has very strict criteria, approves the DS, based on the NIH? Judie The patients and doctors all call it the platinum and as soon as the NIH is
updated the gold standard will change. The NIH is nearly 10 yrs behind right
now.
Dont you find it rather curious that medicare, being a government agency
that has very strict criteria, approves the DS, based on the NIH?
Judie

]]> By: Tanisha Carletta http://www.obesity-surgery.wordpress-by.org/2004/01/30/distal-types-of-surgeries/#comment-1136 Tanisha Carletta Mon, 02 Feb 2004 00:37:25 +0000 http://www.obesity-surgery.wordpress-by.org/2004/01/30/distal-types-of-surgeries/#comment-1136 Medicare goes by the NIH and is a govt agency with strict criteria.....and they do approve the DS! By the way, the DS is considered the "Platinum". Judie Medicare goes by the NIH and is a govt agency with strict criteria…..and
they do approve the DS!
By the way, the DS is considered the “Platinum”.
Judie

]]> By: Tanisha Carletta http://www.obesity-surgery.wordpress-by.org/2004/01/30/distal-types-of-surgeries/#comment-1133 Tanisha Carletta Sun, 01 Feb 2004 03:29:03 +0000 http://www.obesity-surgery.wordpress-by.org/2004/01/30/distal-types-of-surgeries/#comment-1133 Kim, The difference in the proximal/medial/distal RNY has to do with the amount of the intestine bypassed and therefore the amount of malabsorption. Proximal means "nearest", meaning the section of small intestine nearest the stomach. In proximal bypasses, little to none of the small intestine in bypassed and therefore little to no malabsorption takes place. Distal means "distant", meaning the section of small intestine furthest away from the stomach, usually somewhere in the last three to five feet of small intestine. This is the standard amount of intestine bypassed in the DS and induces the largest amount of malabsorption (100cm=3.28'). Medial means "middle" and is somewhere between proximal and distal. In any case, the RNY stomach is always made around 1oz and the pyloric valve is bypassed entirely. Distal RNY patients have almost all of the same intestinal symptoms and malabsorption risks as DS patients, but have a <!--more--> permanently smaller stomach and no pyloric valve. Judie Kim,
The difference in the proximal/medial/distal RNY has to do with the
amount of the intestine bypassed and therefore the amount of
malabsorption. Proximal means “nearest”, meaning the section of
small intestine nearest the stomach. In proximal bypasses, little to
none of the small intestine in bypassed and therefore little to no
malabsorption takes place. Distal means “distant”, meaning the
section of small intestine furthest away from the stomach, usually
somewhere in the last three to five feet of small intestine. This is
the standard amount of intestine bypassed in the DS and induces the
largest amount of malabsorption (100cm=3.28′). Medial means “middle”
and is somewhere between proximal and distal. In any case, the RNY
stomach is always made around 1oz and the pyloric valve is bypassed
entirely. Distal RNY patients have almost all of the same intestinal
symptoms and malabsorption risks as DS patients, but have a

permanently smaller stomach and no pyloric valve.
Judie

]]> By: Jimmy Ramonita http://www.obesity-surgery.wordpress-by.org/2004/01/30/distal-types-of-surgeries/#comment-1132 Jimmy Ramonita Sat, 31 Jan 2004 15:53:20 +0000 http://www.obesity-surgery.wordpress-by.org/2004/01/30/distal-types-of-surgeries/#comment-1132 Dear Kim, There are several different types of weight loss surgery. All of the surgeries can be done with an open incision or laparoscopically, which is done with several tiny incisions. There are many variants to an RNY. Each surgeon makes their pouch a different size and you can be bypassed either proximal, medial or distal. A proximal RNY bypasses a small amount of intestine and therefore has a very small amount of malabsorption. A medical RNY has a little more malabsorption and a distal RNY has the most malabsorption. There is also the Lap Band which is adjustable and goes around your stomach. There is no malabsorption with a Lap Band. There is a VBG, which is not really that popular anymore because of the high failure rate. There is the BPD and the BPD/DS. The BPD is the original surgery done and the newer "model" is the BPD/DS. With the BPD/DS, you have your "real" stomach which has been surgically made smaller. You do <!--more--> not have dumping syndrome with the BPD/DS. The BPD/DS has the best success with higher BMI patients and is proven long term to keep the most weight off. You can go to www.duodenalswitch.com to research this procedure. I chose the BPD/DS because I wanted to lose as much weight as I could without watching or dieting and I never wanted to regain my weight years down the road. I also am able to eat sweets if I chose to and since I only absorb approx. 25% of the fat that I eat I can enjoy a more normal diet and still lose weight. You have to research all of your options and see what surgery best fits your lifestyle and desires. Good luck. Jodi ~ Age 38 yrs. 230/118 (-112 lbs) 5' 3.5" ~ Size 2/4 Lap BPD/DS 4/26/01 Dr. Christine Ren, NYU, NYC www.thinforlife.org please explain these different types? Is Distal something else? What is the main surgery that is recommended here in these groups? I had thought the Rouen Y was the best, but I keep hearing so many other ones I feel to research out some more before settling in. Dear Kim,
There are several different types of weight loss surgery. All of the
surgeries can be done with an open incision or laparoscopically,
which is done with several tiny incisions. There are many variants
to an RNY. Each surgeon makes their pouch a different size and you
can be bypassed either proximal, medial or distal. A proximal RNY
bypasses a small amount of intestine and therefore has a very small
amount of malabsorption. A medical RNY has a little more
malabsorption and a distal RNY has the most malabsorption. There is
also the Lap Band which is adjustable and goes around your stomach.
There is no malabsorption with a Lap Band. There is a VBG, which is
not really that popular anymore because of the high failure rate.
There is the BPD and the BPD/DS. The BPD is the original surgery
done and the newer “model” is the BPD/DS. With the BPD/DS, you have
your “real” stomach which has been surgically made smaller. You do

not have dumping syndrome with the BPD/DS. The BPD/DS has the best
success with higher BMI patients and is proven long term to keep the
most weight off. You can go to www.duodenalswitch.com to research
this procedure. I chose the BPD/DS because I wanted to lose as much
weight as I could without watching or dieting and I never wanted to
regain my weight years down the road. I also am able to eat sweets
if I chose to and since I only absorb approx. 25% of the fat that I
eat I can enjoy a more normal diet and still lose weight. You have
to research all of your options and see what surgery best fits your
lifestyle and desires. Good luck.
Jodi ~ Age 38 yrs.
230/118 (-112 lbs)
5′ 3.5″ ~ Size 2/4
Lap BPD/DS
4/26/01
Dr. Christine Ren, NYU, NYC
www.thinforlife.org

please explain these different types? Is Distal something else?
What is the main surgery that is recommended here in these groups? I
had thought the Rouen Y was the best, but I keep hearing so many
other ones I feel to research out some more before settling in.

]]> By: Rickey Nichols http://www.obesity-surgery.wordpress-by.org/2004/01/30/distal-types-of-surgeries/#comment-1130 Rickey Nichols Sat, 31 Jan 2004 08:40:35 +0000 http://www.obesity-surgery.wordpress-by.org/2004/01/30/distal-types-of-surgeries/#comment-1130 Distal is a type of RNY which has the most bypassed. Medial (what BTC does) is an average length -- not long and not short -- while proximal is bypassing the shortest amount. RNY is considered the gold standard of WLS by the NIH however there is also the BPD/DS which Dr. Hess does, the lapband (which has just been approved in the last two years by the FDA) and the VBG (which fewer are surgeons are doing nowadays due to the failure rate. HTH Denise Rasley mailto:drasley@... BTC, Columbus, 10/7/98 Lost over 90% of excess and maintaining Gained a beautiful daughter on 8/9/00 Distal is a type of RNY which has the most bypassed. Medial (what BTC does)
is an average length — not long and not short — while proximal is
bypassing the shortest amount. RNY is considered the gold standard of WLS by
the NIH however there is also the BPD/DS which Dr. Hess does, the lapband
(which has just been approved in the last two years by the FDA) and the VBG
(which fewer are surgeons are doing nowadays due to the failure rate. HTH
Denise Rasley
mailto:drasley@…
BTC, Columbus, 10/7/98
Lost over 90% of excess and maintaining
Gained a beautiful daughter on 8/9/00

]]> By: harold_2000 http://www.obesity-surgery.wordpress-by.org/2004/01/30/distal-types-of-surgeries/#comment-1127 harold_2000 Fri, 30 Jan 2004 22:41:26 +0000 http://www.obesity-surgery.wordpress-by.org/2004/01/30/distal-types-of-surgeries/#comment-1127 Kim, There are many different types of surgeries and they all have their plusses and minuses. You need to determine which is best for you. www.obesityhelp.com has links to some great informational sites about the different types of surgeries. Distal is a term concerning the length of common channel left after surgery. In other words more intestine is bypassed which leads to greater malabsorbtion than the proximal which has very little malabsorbtion and the medial which is somewhere in the middle. I went for a distal RNY because I didn't want to have to worry about weight gain long term. I don't absorb fats very well, so I don't really have to concern myself about fat content in my diet except if I go overboard, I get diarreah. Also, I dump with sugar so I stay away from anything with more than 8 grams of fat per serving. This also helps me keep the weight off long term. Another surgery that is even more distal than most RNY surgeries is the DS. We have many of those on this list and I'm sure one of them will describe <!--more--> that surgery for you. So do your research and find the surgery that fits your situation the best. Most importantly, find a surgeon that has done this type of surgery for awhile and has a very good record as far as complications and patients lost. A good surgeon, in my opinion, is the most important criteria. Good luck to you! Vicki open RNY 6/28/01 155# and loving life!!! Kim,
There are many different types of surgeries and they all have their plusses
and minuses. You need to determine which is best for you.
www.obesityhelp.com has links to some great informational sites about the
different types of surgeries. Distal is a term concerning the length of
common channel left after surgery. In other words more intestine is bypassed
which leads to greater malabsorbtion than the proximal which has very little
malabsorbtion and the medial which is somewhere in the middle. I went for a
distal RNY because I didn’t want to have to worry about weight gain long
term. I don’t absorb fats very well, so I don’t really have to concern
myself about fat content in my diet except if I go overboard, I get diarreah.
Also, I dump with sugar so I stay away from anything with more than 8 grams
of fat per serving. This also helps me keep the weight off long term.
Another surgery that is even more distal than most RNY surgeries is the DS.
We have many of those on this list and I’m sure one of them will describe

that surgery for you. So do your research and find the surgery that fits
your situation the best. Most importantly, find a surgeon that has done this
type of surgery for awhile and has a very good record as far as complications
and patients lost. A good surgeon, in my opinion, is the most important
criteria. Good luck to you!
Vicki
open RNY 6/28/01
155# and loving life!!!

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