Question:
I'm curious why staples are used.

It seems they have a tendacy to break loose, or build up scar tissue. Doesn'y it seem logical that the stomach be cut away?? Sandi    — goodgal (posted on July 5, 2002)

July 5, 2002
Staples are used even with transection (cutting away). When the stapler/cutter fires it cuts/separates the old stomach and new pouch into. With staples, you want to form scar tissue around the cut edge. That is what makes the pouch a tight seal. The trouble with NOT cutting the two apart and just stapling is that scar tissue has a hard time (I don't even know if it ever does...not sure) forming when the stomach is just stapling. It was explained to me like this: when the stomach is stapled, there is no possibility for the two edges to form scar tissue because it is just like putting two intact fingers together, they will not ever form scar tissue but if the organ is cut into two separate entities, the scar tissue (actually healing) forms quickly and seals the pouch and the old stomach apart. It seems logical to me also that all surgeons would transect but they don't. I had a disruption with 8 rows of staples and when I had the revision to transect, my surgeon said he saw no sign of the staples that had come loose. They were at the very top of my pouch forming a small leak. The food would overflow into the old stomach. There was no danger of that because the old stomach at that time was still attached. With transection, the danger of a leak in the first few days after surgery is riskier because if this would happen the food would leak into the body possibly causing peritonitis. That is why we get no food for a few days until it is certain we have no leak. With transection, after the first few days (you are still in the hospital usually at this time), the chance of a staple line disruption is almost zero. I am transected now and if I were preop, I would not have rny without transection. Two surgeries in one year was pretty tough but the result is great. - 107 lbs!
   — Marilyn C.

July 5, 2002
Yes. Whatyou said, what Marilyn said. But as to WHY they don't? Many are not involved with the latest studies, some are afraid of the peritonitis leaks, some are just scared, and there a few I am convinced do a non-transected staple line because it will generate another surgery. No, not naming names. At the conf, there are now devises & materials that can be stapled right into the trtansected stomach that add additional sealing, much as a binding in your clothes. Fascinating. So, it CAn be done lap, just added right onto the stapler & ka-chunk, cuts, staples & binds simultaneously. Seemed to be a popular booth, too, which I was happy to see. Since I'm not a surgeon, I didn't catch the name, but I did catch the concept & I thought it great, since my husband did have a post-op leak, but at the stoma. But yes, I saw almost nothing on non-transected products OR even pix of posters (by docs) with the old "just stapled" partition.
   — vitalady

July 5, 2002
Michelle please tell us more of what you learned at thwe conference.
   — faybay

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