Re: Re: WLS...The Easy Way Out???

[Guest guest]

In a message dated 4/29/01 11:10:33 AM, duodenalswitch writes:

<< She is a distal RNY, so her lower part is quite similar to ours. She has

more restrictive pouch though.

>>

Dawn: I think that the distal RNY has a very different intestinal arrangement

than the DS. It is the same as the proximal RNY only that more intestines

are bypassed. The DS involves creating two separate 'limbs' that carry

bile/pancreatic juices and chyme (processed food). These two limbs do not

meet until the last 100 cm (give or take) of the common channel. I mean, the

operations are similar in that there is less absorption occuring but in the

distal RNY (as I understand it and correct me if I'm wrong here), a

percentage of intestines are actually bypassed (ie. - not used) whereas all

of our intestines are utilized but absorption doesn't occur because the

juices and chyme are separated.

all the best,

[Guest guest]

In a message dated 04/29/2001 10:24:37 AM Central Daylight Time,

ruisha@... writes:

<< but in the

distal RNY (as I understand it and correct me if I'm wrong here), a

percentage of intestines are actually bypassed (ie. - not used) whereas all

of our intestines are utilized but absorption doesn't occur because the

juices and chyme are separated. >>

I am almost sure that there is no intestine left idle. That would create

severe medical problems like the old bypasses did. The only part that is

left idle is the lower stomach. The Distal RNY is often not as " distal " as

the BPD/DS but otherwise the intestinal part is the same. But of course the

intestines are hooked to a pouch rather than have a connection with a portion

of the duodendum that was separated near the stomach.

Dawn

BPD/DS

Dr. Hess, Bowling Green, OH

267 to 165

size 22 to size 10

5'4 "

no more high blood pressure, sore feet, or dieting!!

have met size goal, weight goal to be adjusted!

[Guest guest]

In a message dated 04/29/2001 10:24:37 AM Central Daylight Time,

ruisha@... writes:

<< but in the

distal RNY (as I understand it and correct me if I'm wrong here), a

percentage of intestines are actually bypassed (ie. - not used) whereas all

of our intestines are utilized but absorption doesn't occur because the

juices and chyme are separated. >>

I am almost sure that there is no intestine left idle. That would create

severe medical problems like the old bypasses did. The only part that is

left idle is the lower stomach. The Distal RNY is often not as " distal " as

the BPD/DS but otherwise the intestinal part is the same. But of course the

intestines are hooked to a pouch rather than have a connection with a portion

of the duodendum that was separated near the stomach.

Dawn

BPD/DS

Dr. Hess, Bowling Green, OH

267 to 165

size 22 to size 10

5'4 "

no more high blood pressure, sore feet, or dieting!!

have met size goal, weight goal to be adjusted!

[Guest guest]

In a message dated 04/29/2001 10:24:37 AM Central Daylight Time,

ruisha@... writes:

<< but in the

distal RNY (as I understand it and correct me if I'm wrong here), a

percentage of intestines are actually bypassed (ie. - not used) whereas all

of our intestines are utilized but absorption doesn't occur because the

juices and chyme are separated. >>

I am almost sure that there is no intestine left idle. That would create

severe medical problems like the old bypasses did. The only part that is

left idle is the lower stomach. The Distal RNY is often not as " distal " as

the BPD/DS but otherwise the intestinal part is the same. But of course the

intestines are hooked to a pouch rather than have a connection with a portion

of the duodendum that was separated near the stomach.

Dawn

BPD/DS

Dr. Hess, Bowling Green, OH

267 to 165

size 22 to size 10

5'4 "

no more high blood pressure, sore feet, or dieting!!

have met size goal, weight goal to be adjusted!

[Guest guest]

Yes, the bile ducts empty into the biliary limb right below the blind closed

off end. The enzymes flow downward through the biliary limb and into the

common channel after the Y.

The alimentary limb conveys the food from the stomach down. The

malabsorption part of the DS surgery is because those enzymes aren't around

to help absorb all that fat while food travels down the alimentary limb.

Fat and protein digestion happens in those final 75-100 cm where the enzymes

from the liver and pancreas meet the food.

in Seattle

----- Original Message -----

> Our

>

> upper biliary limb is blind, closed off, not attached to the

stomach......>>>>

>

> Oh, see - I thought it was attached to the bile ducts or something like

that

> and that's why the bile/pancreatic juices flow through the alimentary

limb!

>

> all the best,

>

[Guest guest]

Yes, the bile ducts empty into the biliary limb right below the blind closed

off end. The enzymes flow downward through the biliary limb and into the

common channel after the Y.

The alimentary limb conveys the food from the stomach down. The

malabsorption part of the DS surgery is because those enzymes aren't around

to help absorb all that fat while food travels down the alimentary limb.

Fat and protein digestion happens in those final 75-100 cm where the enzymes

from the liver and pancreas meet the food.

in Seattle

----- Original Message -----

> Our

>

> upper biliary limb is blind, closed off, not attached to the

stomach......>>>>

>

> Oh, see - I thought it was attached to the bile ducts or something like

that

> and that's why the bile/pancreatic juices flow through the alimentary

limb!

>

> all the best,

>

[Guest guest]

In a message dated 4/30/01 3:15:35 AM, duodenalswitch writes:

<< Yes, the bile ducts empty into the biliary limb right below the blind

closed

off end. The enzymes flow downward through the biliary limb and into the

common channel after the Y.

The alimentary limb conveys the food from the stomach down. The

malabsorption part of the DS surgery is because those enzymes aren't around

to help absorb all that fat while food travels down the alimentary limb.

Fat and protein digestion happens in those final 75-100 cm where the enzymes

from the liver and pancreas meet the food.

>>

So distal and proximal RNY also have a blind limb into which enzymes flow?

I didn't think the enzymes and chyme were separated as in the DS and that's

what was so special about the bilio-pancreatic diversion (besides the stomach

difference). I thought the distal RNY was only different from the proximal

in the amount of intestines bypassed and that's where the malapsorption came

from -

not from the same intestinal arrangement as the DS.

All the best,

[Guest guest]

In a message dated 4/30/01 2:51:07 PM, duodenalswitch writes:

<< The malabsorption of the RNY is minor with a proximal. With the distal it

is major. I attended support meetings and me some of Dr Fox's patients with

distal RNYs. Because of the tiny stomachs they had, some of the lived on

supplements, not food. From my personal viewpoint, albeit biased, it is

this ability to lead a relatively normal life, eating meals, not living on

protein drinks, that distinguishes the DS post op life from that the RNY

post ops. (Many people with the RNY don't have dumping syndrome.) For me

it is a quality of life issue.

>>

Oh, I definately agree that a distal RNy just really doesn't make much

health/nutritional sense. If one has decided on a distal operation, the DS

is the way to go, imho. I also think that the DS beats the proximal RNY in

terms of quality of life issues but can understand why someone would prefer

not to have a distal surgery.

All the best,

teresa

[Guest guest]

No, the RNY doesn't have a blind limb. It is still attached to the remnant

stomach (where no food ever goes). The enzymes enter this limb and flow

down to the Y as per the DS.

Yes, the difference between the distal and proximal bypass of the RNY is

talking about how much of that alimentary limb is bypassed. The proximal

bypass is the norm for the RNY. However, there are some RNY surgeons who

offer a distal bypass very much like that of the DS. Dr Fox in Tacoma, WA

talks about the differences between the distal, medial and proximal RNYs he

does. The shortest (most distal) common channel he does is about 50cm, as I

recall.

The malabsorption of the RNY is minor with a proximal. With the distal it

is major. I attended support meetings and me some of Dr Fox's patients with

distal RNYs. Because of the tiny stomachs they had, some of the lived on

supplements, not food. From my personal viewpoint, albeit biased, it is

this ability to lead a relatively normal life, eating meals, not living on

protein drinks, that distinguishes the DS post op life from that the RNY

post ops. (Many people with the RNY don't have dumping syndrome.) For me

it is a quality of life issue.

in Seattle

----- Original Message -----

>

> So distal and proximal RNY also have a blind limb into which enzymes flow?

> I didn't think the enzymes and chyme were separated as in the DS and

that's

> what was so special about the bilio-pancreatic diversion (besides the

stomach

> difference). I thought the distal RNY was only different from the

proximal

> in the amount of intestines bypassed and that's where the malapsorption

came

> from -

> not from the same intestinal arrangement as the DS.

>

> All the best,

>

>

>

>

> ----------------------------------------------------------------------

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