RNY to DS revision

Hi

Just wanted to know where in the post op report of the RNY surgery can you tell if you have a non-transected pouch? I am hearing that during the revision leaks occur in patients who had non-transcted pouches.


Thanks
Dana

I'm a little confused about why people say this. I guess I'm wrong, but I thought typical RNY pouches were non transected.

I had a fobi pouch, which has a transected pouch. This means that it had to be converted to a normal RNY pouch before being reversed. According to Keshishian this increased the risk of leaks by about 100%

Anyhow, I'm sorry it's a confusing topic. I hope someone can give you a better answer, but I want to reassure you that Keshishian is the genius of RNY revisions. He's revised every type of pouch you can think of.  My revision was more invasive than a standard RNY revision, and he pulled it off without a hitch. The only difference was that I needed more time in the hospital to allow the swelling to go down.

I remember that I was really nervous before my revision.Try not to dwell on it too much. My quality of life has improved 1,000,000%, and I would do it over in a heart beat.

I'm jw what your surgery date it?

A leak can occur with either a transected or non-transected stomach from your RNY. A leak can occur in someone with no prior surgery as well, it's just less likely.
     Your potential revision surgeon can review the operative report for you and sort out what was or wasn't done, and clarify for you just how much risk you would be facing.

Larra

Surgeons perform RNYs either by stapling the stomach and leaving the latent stomach intact and then creating an stoma to which the intestines are attached to for the food to exit from. The other way the pouch can be performed is to cut a pouch and then transect the latent stomach from the pouch and to pu**** down father away from the pouch so that it won't reattach. A stoma is then made and the intestines are then hooked up to the stoma to allow the food to exit.

Data, according to my surgeon and his own personal experience shows that when revising from a NON transected pouch to DS that gastric leak incident is higher than when a revision from a transected pouch to DS is performed. I'm told that a lot of the reason is blood flow and having to take down the staple line from across the non transected stomach, then having a sleeve created.  Evidently it has a lot to do with trauma and blood flow to the stomach. The transected pouch has had time to adjust to the reduced blood flow. I'm not sure I understand all the details regarding it, but it also had something to do with opening up the bottom part of the pouch and it having a better healing rate.  Gastric leak can occur with a virgin DS, though the percentages are lower.  You could always email Dr. Greenbaum at [email protected] for a more complete explaination regarding the data and why some doctors are less inclined to do a revision to DS on a non-transected pouch.

Given my own personal experience, I had a non transected (10 year post op) pouch and had a gastric leak, along with a plethora of other post op complications as well. 

I'm sure you have read it, but if you haven't you should read this if you are considering a revision. 
http://www.obesityhelp.com/forums/revision/4321652/If-you-ar e-considering-a-revision-from-RNY-to-DS-you-should/

Warmly, 
Maddie