Question:
I have an appointment with a VERY established surgeon that does not transect
He has done a couple thousand surgeries with "only" two deaths. However, he does NOT transect. I would like to know what the percentage rate of a Staple Line Disruption is? AND one hypothetical question. If the SLD was not a possibility would you still chose a transected surgery over just staples? THanks! — SJP (posted on May 5, 2003)
May 5, 2003
I would ask him how many disruptions he gets. For ME if it werent for SLDs
I wouldnt care about transected or not. Go into it being aware you may get
ulcers, or need another surgery in the future. Good luck in whatever you
choose.
— bob-haller
May 5, 2003
Let me clarify the last part of my question. Are the risks greater with a
transected pouch versus no transection? I know that it is easier to
reverse the surgery with no transection but what about other possible
complications?
thanks
— SJP
May 5, 2003
What %? After how many years? By 10 yrs? By 5? By the 2nd year? Most of
the ones I've seen are needing revision before 2 yrs. I SLD at the 5 yrs
mark & my closest surgery sister made it 7 yrs. Of our original
support group from 94-95, only ONE has not disrupted. My dh & I surely
don't know why. He's never been as fastidious as I have regarding portions
& all that. However, SLD is the body's reaction to the "foreign
invaders", not to somethign WE do. Since I had the opportunity to do
both, I would still transect. AS it is, some bodies are so determined to
return to our versino of normal that the 2 stomachs find each other and
form a bridge (fistula) to reconnect! Knowing me, that'd happen. Doing
this surgery once takes a lot of guts. Doing it over & over, well.....
— vitalady
May 5, 2003
I would not even consider a surgeon who did not transect. That is my
opinion.
— sandieguy
May 5, 2003
i would not have rny wls surgery with out transection. why risk it?
— janetc00
May 5, 2003
i wouldn't risk this surgery w/o a transection either..Look for another
doctor that does.
good luck!
~muffy~
ps btw, i never heard of such a bad offer~ i had 100cm
— leslie M.
May 5, 2003
I had my open RNY one year ago today, not transected and no problems (knock
on wood!) The SLD factor does worry me sometimes, but it wouldn't stop me
from using the same surgeon again.
Good luck.
— KelBurt
May 5, 2003
Hi~ I would only have this surgery if he did "completly seperate"
transect. SLD is a very real possibility. It happens "alot" I
don't think it has so much to do with your surgeon as it does with how hard
is "your" body going to fight to correct itself and pop the
staples out. You will be at a greater risk to have to have a revision. I
would ask again is there anything else that he does to prevent this from
happening. Good Luck!!
— latrishanickle
May 5, 2003
I respect whatever surgeon and procedure anyone feels is appropriate for
them. However, I would not have chosen to have surgery if I could not have
been transected. Seems like not transecting leaves too many variables.
Just my personal choice. I hope you have much success regardless of which
procedure you choose!!
— ronascott
May 6, 2003
i agree qwith the previous poster, in fast i responded to this last night
and it did not show up, i wouold not have rny wls if not transected, too
many potential problems why risk it.
— janetc00
May 6, 2003
I was quoted a 1-3% chance of SLD by my surgeon. He does not transect. I
am quite happy with my surgery - transection or no transection. If
somewhere down the road, I end up with a SLD, then I will deal with it
then. No one knows what is going to transpire in the future for each
individual. All you have are percentages.
<p>
Having this surgery was the greatest thing that has ever happened to me.
I've lost 172 pounds in the last 9 1/2 months and I am still losing. My
wife is undergoing her WLS as I type this on 5/6 (typing from HUP's
surgical waiting lounge) and she's not transected either.
<p>
I think that if you have an excellent surgeon that you are very confident
in, you should stick with that surgeon and don't worry about
transection/non-transection. This is one of those subjects on AMOS that
is always guaranteed to get a bunch of posts...JR (open RNY/non-transected
07/17/02 -172 pounds)
— John Rushton
May 6, 2003
AMOS MOD HERE.<P> I have reported a board bug, things appear to be
going backwards a bit. There are isolated reports of missing posts. Sorry
for the inconvenience, hopefully it will be fixed soon. If you post any big
posts pleas save a copy in case it disappears.
— bob-haller
May 6, 2003
I would not have this surgery if the surgeon did not transect. My opinion
and experience since I had a SLD and had to go back to be transected. Two
surgeries vs one surgery? No contest! I think a lot more people disrupt
than the statistics show because it can happen at any time and the person
would not even realize it. I had no symptoms other than not losing after a
68 lb loss. Perhaps a lot of people have disruption and just think they
are a failure or the surgery failed. The guilt without understanding WHY
it happens can be devastating. WHY does staple line disruption occur? My
surgeon says that the two smooth edges of the cut do not form scar tissue
if they are still attached (even though 8 rows of staples were used in my
first rny). He said if you separate the two edges then scar tissue forms
and seals. Maybe some people form more scar tissue than others and it
seals even w/out transection. I dont know but I feel the chance of
disruption without transection is too great. Immediately post op the
surgery w/out transection is a little safer because if there is a leak, the
contents of the stomach fill the still attached stomach. With transection
immediately postop the contents would go into the body if there was a leak.
BUT with transection, the scar tissue forms quickly and you are still in
the hospital if a leak develops and is discovered. If peritonitis
developed, you would get a temp and the surgeon would intervene to fix the
leak. By the time you go home the chance of a leak are very unlikely. If
you feel confident with your surgeon and he doesn't transect, follow your
instincts. By the way, have you ever asked him why he doesn't transect?
Good luck in whatever you decide.
— Mylou52
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