Re: Confused about Staple Line Disruption

[Guest guest]

Bill:

I missed it at first as well. But as I understand it, if the stomach is

transected, you have cut edges of stomach tissue that actually heal by

growing together. So with staples, it's just the staples sealing the

compartments....the tissues don't grow together and form a seal....it's

purely mechanical subject to rejection or failure. With transection, it's

staples PLUS the edges of the stomach actually growing back together, like

any other surgical incision. I think Ray's comment was correct, that if

it's right after surgery it's probably technically a " leak " or failure of

the recent surgery itself. Later on, I think transected stomachs are far

less likely to leak or failure since the tissue has grown back together.

This is just what I've picked up from asking questions.

I wish I had been transected, although I had an upper GI and mine is still

just fine!

in Austin

RNY April 1998

Confused about Staple Line Disruption

> Could someone please explain how transcetion of the stomach can possibly

> eliminate SLD. To me at least they would seem to not be related at all.

> Either way the pouch is stapled, if the stomach is transceted then the

> disruption of the staple line would most likely be fatal, without the

> transcetion the result would just be a failure of the staple line and the

> contents of the pouch would enter into the old stomach. Right?

[Guest guest]

Bill:

I missed it at first as well. But as I understand it, if the stomach is

transected, you have cut edges of stomach tissue that actually heal by

growing together. So with staples, it's just the staples sealing the

compartments....the tissues don't grow together and form a seal....it's

purely mechanical subject to rejection or failure. With transection, it's

staples PLUS the edges of the stomach actually growing back together, like

any other surgical incision. I think Ray's comment was correct, that if

it's right after surgery it's probably technically a " leak " or failure of

the recent surgery itself. Later on, I think transected stomachs are far

less likely to leak or failure since the tissue has grown back together.

This is just what I've picked up from asking questions.

I wish I had been transected, although I had an upper GI and mine is still

just fine!

in Austin

RNY April 1998

Confused about Staple Line Disruption

> Could someone please explain how transcetion of the stomach can possibly

> eliminate SLD. To me at least they would seem to not be related at all.

> Either way the pouch is stapled, if the stomach is transceted then the

> disruption of the staple line would most likely be fatal, without the

> transcetion the result would just be a failure of the staple line and the

> contents of the pouch would enter into the old stomach. Right?

[Guest guest]

Bill:

I missed it at first as well. But as I understand it, if the stomach is

transected, you have cut edges of stomach tissue that actually heal by

growing together. So with staples, it's just the staples sealing the

compartments....the tissues don't grow together and form a seal....it's

purely mechanical subject to rejection or failure. With transection, it's

staples PLUS the edges of the stomach actually growing back together, like

any other surgical incision. I think Ray's comment was correct, that if

it's right after surgery it's probably technically a " leak " or failure of

the recent surgery itself. Later on, I think transected stomachs are far

less likely to leak or failure since the tissue has grown back together.

This is just what I've picked up from asking questions.

I wish I had been transected, although I had an upper GI and mine is still

just fine!

in Austin

RNY April 1998

Confused about Staple Line Disruption

> Could someone please explain how transcetion of the stomach can possibly

> eliminate SLD. To me at least they would seem to not be related at all.

> Either way the pouch is stapled, if the stomach is transceted then the

> disruption of the staple line would most likely be fatal, without the

> transcetion the result would just be a failure of the staple line and the

> contents of the pouch would enter into the old stomach. Right?

[Guest guest]

Good explanation! That is how my doc explains it also. He staples several

rows, transects and also oversews the edges to give it an even better seal. As

far as I know, no one who he has done this way has ever had an SLD, although

when he used to do the non -transected method years ago, he had several that did

get an SLD and had to be revised.

Chrissie

shihtzumom@...

http://users.snip.net/~shihtzumom

My WLS Journey:

http://millennium.fortunecity.com/doddington/691/WLS/this_is_me.htm

Re: Confused about Staple Line Disruption

Bill:

I missed it at first as well. But as I understand it, if the stomach is

transected, you have cut edges of stomach tissue that actually heal by

growing together. So with staples, it's just the staples sealing the

compartments....the tissues don't grow together and form a seal....it's

purely mechanical subject to rejection or failure. With transection, it's

staples PLUS the edges of the stomach actually growing back together, like

any other surgical incision. I think Ray's comment was correct, that if

it's right after surgery it's probably technically a " leak " or failure of

the recent surgery itself. Later on, I think transected stomachs are far

less likely to leak or failure since the tissue has grown back together.

This is just what I've picked up from asking questions.

I wish I had been transected, although I had an upper GI and mine is still

just fine!

[Guest guest]

Good explanation! That is how my doc explains it also. He staples several

rows, transects and also oversews the edges to give it an even better seal. As

far as I know, no one who he has done this way has ever had an SLD, although

when he used to do the non -transected method years ago, he had several that did

get an SLD and had to be revised.

Chrissie

shihtzumom@...

http://users.snip.net/~shihtzumom

My WLS Journey:

http://millennium.fortunecity.com/doddington/691/WLS/this_is_me.htm

Re: Confused about Staple Line Disruption

Bill:

I missed it at first as well. But as I understand it, if the stomach is

transected, you have cut edges of stomach tissue that actually heal by

growing together. So with staples, it's just the staples sealing the

compartments....the tissues don't grow together and form a seal....it's

purely mechanical subject to rejection or failure. With transection, it's

staples PLUS the edges of the stomach actually growing back together, like

any other surgical incision. I think Ray's comment was correct, that if

it's right after surgery it's probably technically a " leak " or failure of

the recent surgery itself. Later on, I think transected stomachs are far

less likely to leak or failure since the tissue has grown back together.

This is just what I've picked up from asking questions.

I wish I had been transected, although I had an upper GI and mine is still

just fine!

[Guest guest]

Good explanation! That is how my doc explains it also. He staples several

rows, transects and also oversews the edges to give it an even better seal. As

far as I know, no one who he has done this way has ever had an SLD, although

when he used to do the non -transected method years ago, he had several that did

get an SLD and had to be revised.

Chrissie

shihtzumom@...

http://users.snip.net/~shihtzumom

My WLS Journey:

http://millennium.fortunecity.com/doddington/691/WLS/this_is_me.htm

Re: Confused about Staple Line Disruption

Bill:

I missed it at first as well. But as I understand it, if the stomach is

transected, you have cut edges of stomach tissue that actually heal by

growing together. So with staples, it's just the staples sealing the

compartments....the tissues don't grow together and form a seal....it's

purely mechanical subject to rejection or failure. With transection, it's

staples PLUS the edges of the stomach actually growing back together, like

any other surgical incision. I think Ray's comment was correct, that if

it's right after surgery it's probably technically a " leak " or failure of

the recent surgery itself. Later on, I think transected stomachs are far

less likely to leak or failure since the tissue has grown back together.

This is just what I've picked up from asking questions.

I wish I had been transected, although I had an upper GI and mine is still

just fine!

[Guest guest]

& Watnext did a fine job of explaining how 2 raw edges seal and the

stapled slimy portions don't. I liken the original stapled stomach (of

which I was one, yes, RNY, but not transected) to a pocket sewn onto a

shirt, kinda. Even if you do not put anything into the pocket, but keep

wearing the shirt, the edges begin to lift, the thread just wears out. The

first pieces will out live the seam line. That's not the best analogy, but

you sorta get the drift.

That's very different thing than the post-op leak, in which the staples

didn't " take " completely via equipment failure, surgeon error, or " my body

doesn't want this " type. Blame need not be assigned. That one can b e

deadly. My husband had post-op leak at the stoma, and had to be reopened on

Day 5. He's fine now. He still has a non-transected staple line. (which

had no bearing on this)

Then the final thing I would add is that yes, post-op leak (although not the

same as SLD in the sense we are discussing here) could certainly be fatal,

and quickly. However, that risk is generally considered to be gone by Day

10.

A way down the road SLD, like mine or others does allow the food to pass

into the old stomach, just as you surmise. However, in some cases, when the

full fledged morbid obesity returns, THAT can be fatal, as well. For some

SLD is nothing more than a mysterious regain. For me, instant pain. For

others, it may mean a many years long battle with insurance.

My docs changed their ways in 1996. Lucky them, but I spose maybe I should

be thankful, as the SLD (and the wait for revision) certainly refueled my

desire to do what needed to be done on MY part, the only part *I* can

control. Just as I think my initial insurance battle set me up with a more

desperate need to be moderately successful (i.e., hold a reasonable wt),

perhaps that " speed bump " in my life was like a refresher course for me in

" why I do what I do " .

I'm sure that's way more philosophical than you wanted to go! LOL! But the

other explanations are all very clear. I just added back the emotional part

of SLD. It's devastating to watch your tool crash out from under you. Like

watching one of your tires roll down the road, KNOWING what will happen.

Thanks,

Vitalady T

www.vitalady.com

If you are interested in PayPal, please click here:

https://secure.paypal.com/affil/pal=vitalady%40bigfoot.com

Confused about Staple Line Disruption

> Okay just when you think you know everything, someone brings up a thread

to

> confuse you.

>

> Could someone please explain how transcetion of the stomach can possibly

> eliminate SLD. To me at least they would seem to not be related at all.

> Either way the pouch is stapled, if the stomach is transceted then the

> disruption of the staple line would most likely be fatal, without the

> transcetion the result would just be a failure of the staple line and the

> contents of the pouch would enter into the old stomach. Right? Given

these

> choices, I would take the later anyday, I may regain the weight but at

least

> I would survive and could have a revision. The mere fact that the pouch

was

> cut from the stomach should not impact the likelihood or the unlikehood of

a

> SLD, I would not think.

>

> What am I missing here?

>

> Bill in WV

> Open RNY July 7, 1999

> Dr. Harvey J. Sugerman

> Medical College of Virginia, Richmond VA

> Preop Weight 423

> Current Weight 211

> 212 lbs. gone but certainly not forgotten.

> Check out my website at:http://openrny.homestead.com/WLS.htmlhttp://openrny.homestead.com/WLS.html

>

> Homepage: http://groups.yahoo.com/group/Graduate-OSSG

>

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