RNY Gastric Bypass revised to Distal

[thancock 3]

Has anyone had revision surgery from RNY GB to Distal?

[Sharon B A 113]

Yes, i did.. did they only do the malabsorption part of the surgery?

[New&Improved 1,780]

What is distal

[KarenLR75 496]

Um, this is all I could come up with and now it has made me want to ask my Dr. as I never knew there was RNY Proximal and RNY Distal. It's like the more I learn, the less I know.

Here is the info on distal that I found. Someone set me straight if this is wrong. Since my BMI at one time was about 60 and when I met my surgeon it was in the mid 50's - I now wonder....if our Dr doesn't say do those of us who have RNY "assume" we had proximal rather than distal? I qualify..and still do in the super obese group.

RNY Gastric Bypass (Distal)- usually performed for patients who are in the super obese group (BMI over 50).

Depending on their obesity, more small intestines are bypassed when the obesity is more severe to help them lose more weight. When more intestines are bypassed, there will be less intestinal surface for absorption of calories, especially fat. This results in more frequent bowel movements per day. If fat is consumed in the diet, fat will be digested less, and will be eliminated undigested. This may create foul smelling, loose stools.

Indication for this procedure is reserved for bigger patients, or for those patients who have failed their original gastric bypass.

Patients with the distal gastric bypass may need other fat soluble Vitamin supplements, such as Vitamin A, D, E, and K, depends on how long their small intestine is bypassed. Patient follow up is very important to make sure they are metabolically and nutritionally healthy.

[New&Improved 1,780]

That's news to me also I thought there would be a standard procedure for this bypass? Or do surgeons alter things if need be?

I hope my surgeon does the best procedure possible.

My BMI is only 43 not 50 though

[KarenLR75 496]

Mikeyy, it's definitely going on my list of questions for my Dr. I'd like to think that all of us have chosen wisely and our surgeons do..as you said, the best procedure possible...but now I am SO CURIOUS.

That is great that your BMI is lower! Since the definition I pasted was one of several...hundreds in my google search..I skimmed just a few but they all seemed to talk bout ppl with higher BMI's. My doctor likes to educate so I gonna run it by him just for grins

[FluffyChix 17,410]

Most of us who have RNY today, get the proximal surgery because of how extreme the distal is. It also carries more post surgical long term risk due to Vitamin and mineral deficiencies that may only show up years down the road. So distal is a revision surgery (usually).

Also, today, most super MO peeps get VSG as their 1 st surgery cuz the risk of surgery is less, quicker surgery, etc. Then they get revisions to either RNY or DS. Most go from VSG to DS (malabsorption element and VSG anatomy).

[RickM 1,747]

11 hours ago, Mikeyy said:

That's news to me also I thought there would be a standard procedure for this bypass? Or do surgeons alter things if need be?

I hope my surgeon does the best procedure possible.

My BMI is only 43 not 50 though

Here in the States, the proximal is the default, and there are specific standards of care that are defined within the insurance billing codes; the distal is outside of that standard and is not usually approved as an initial surgery, but can be justified as a revision if deemed appropriate. Here, for the higher BMI cases that need something stronger than a VSG or proximal RNY, the duodenal switch is the normally approved procedure.

My wife's surgeon noted at one time that on the occasions that he still did a bypass (their preferred is the duodenal switch) that he liked to make them as malabsorptive as the codes permitted, which is still far short of what a distal would provide.