Comments on: Distal? — Proximal?

By: Phoebe Tyesha

Phoebe Tyesha — Wed, 01 Jun 2005 04:13:57 +0000

> Let’s assume that we all start with 300" of (small) intestine. We
don’t,
but we need to have a figure, so that’s it. From the pix you’ve seen of
RNY/gastric bypass, you know there is a left side, right side and tail
of
the Y. The "junction" of the sides is the determiner if a procedure is
proximal or distal.
>
> The original intestine comes out of the old stomach and carries the
digestive juices that are manufactured in the old stomach. This piece
is
called the bileo-pancreatic limb because it carries bile from the
gallbladder and pancreatic juice from the pancreas. There is no food
here.
This is the LEFT side of the Y. This is the portion that is bypassed.

>
> The alimentary limb connects to the pouch and only carries food, but
cannot digest or absorb. This is the RIGHT side of the Y.
>
> The tail of the Y is where both elements mix together and where
digestion
(if any) and whatever absorption will occur. This is the part that is
still
in use and is also referred to as the common channel.
>
> If the junction of the Y occurs in near proximity to the stomach, it
is
said to be proximal. If the junction occurs as a far distance from the
stomach, it is said to be distal. That said, neither word describes any
actual measurements of anything, so the meaning is in the mind of the
person
speaking of the procedure. What is proximal to my doctor is considered
distal by another.
>
> Generally speaking, ALL RNY people will have to supplement at least
the
basic 8 elements, though in varying doses. We are all missing the
stomach
and its normal digestive function.
>
> Truly distal (with a lot bypassed, and a short common channel) people
need
to supplement in larger volume, but will achieve and maintain the better
weight loss over time. Proximal (less bypassed, longer common channel)
people still need to supplement the basics and can reach a reasonable
weight, but after 2 years may have to work a little harder to maintain
their
goal weight.
>
> My doctor measures what is in use, not what is not. So, in my case, I
have a 40" common channel, then 60" was used to reach the pouch. The
bypassed portion is then ABOUT 200".
>
> Most procedures performed are measured backwards from that. The doctor
will bypass 12 to 72", use 60-80" for the right side of the Y, and the
common channel will be 100-200".
>
>Thanks
Michelle (vitalady)

Would one of you have an answer for me or direct me to about where in
the archive to look again.

Thank you in advance

Marie — San Leandro, CA

By: Joni Glover

Joni Glover — Wed, 01 Jun 2005 00:56:42 +0000

Would one of you have an answer for me or direct me to about where in
the archive to look again.

Thank you in advance

Marie — San Leandro, CA

By: Phoebe Tyesha

Phoebe Tyesha — Tue, 31 May 2005 12:11:35 +0000

Would one of you have an answer for me or direct me to about where in
the archive to look again.

Thank you in advance

Marie — San Leandro, CA

By: Joni Glover

Joni Glover — Tue, 31 May 2005 08:54:20 +0000

Would one of you have an answer for me or direct me to about where in
the archive to look again.

Thank you in advance

Marie — San Leandro, CA

By: Phoebe Tyesha

Phoebe Tyesha — Tue, 31 May 2005 01:30:00 +0000

Patricia, I’m going to paste Michelle Curran’s description of distal vs
proximal.

> Let’s assume that we all start with 300" of (small) intestine. We
don’t,
but we need to have a figure, so that’s it. From the pix you’ve seen of
RNY/gastric bypass, you know there is a left side, right side and tail
of
the Y. The "junction" of the sides is the determiner if a procedure is
proximal or distal.
>
> The original intestine comes out of the old stomach and carries the
digestive juices that are manufactured in the old stomach. This piece
is
called the bileo-pancreatic limb because it carries bile from the

gallbladder and pancreatic juice from the pancreas. There is no food
here.
This is the LEFT side of the Y. This is the portion that is bypassed.
>
> The alimentary limb connects to the pouch and only carries food, but
cannot digest or absorb. This is the RIGHT side of the Y.
>
> The tail of the Y is where both elements mix together and where
digestion
(if any) and whatever absorption will occur. This is the part that is
still
in use and is also referred to as the common channel.
>
> If the junction of the Y occurs in near proximity to the stomach, it
is
said to be proximal. If the junction occurs as a far distance from the
stomach, it is said to be distal. That said, neither word describes any
actual measurements of anything, so the meaning is in the mind of the
person
speaking of the procedure. What is proximal to my doctor is considered
distal by another.
>
> Generally speaking, ALL RNY people will have to supplement at least
the
basic 8 elements, though in varying doses. We are all missing the
stomach
and its normal digestive function.
>
> Truly distal (with a lot bypassed, and a short common channel) people
need
to supplement in larger volume, but will achieve and maintain the better
weight loss over time. Proximal (less bypassed, longer common channel)
people still need to supplement the basics and can reach a reasonable
weight, but after 2 years may have to work a little harder to maintain
their
goal weight.
>
> My doctor measures what is in use, not what is not. So, in my case, I
have a 40" common channel, then 60" was used to reach the pouch. The
bypassed portion is then ABOUT 200".
>
> Most procedures performed are measured backwards from that. The doctor
will bypass 12 to 72", use 60-80" for the right side of the Y, and the
common channel will be 100-200".
>
>Thanks
Michelle (vitalady)

Would one of you have an answer for me or direct me to about where in
the archive to look again.

Thank you in advance

Marie — San Leandro, CA

By: Joni Glover

Joni Glover — Sun, 29 May 2005 03:26:28 +0000

-Michelle

By: Maximo Velva

Maximo Velva — Sat, 28 May 2005 21:46:18 +0000

From what I understand, distal rny involves more of the small intestine to
be bypassed. (Over 120 cms) Proximal, not as much is bypassed. I’ve seen
this topic before, but I can’t remember the exact numbers.

-Michelle

By: Joni Glover

Joni Glover — Sat, 28 May 2005 00:42:31 +0000

Would one of you have an answer for me or direct me to about where in the
archive to look again.

Thank you in advance

Marie — San Leandro, CA