Has anyone heard of an MD not doing a swallow test after RNY?

I don't know for sure, but maybe he does some type of 'test' in the OR? He must be confident in his abilities or some type of experience I guess.

I didn't have a swallow test either.  My surgeon was doing them until about a year and a half ago and they just weren't finding any leaks at all, especially since they check thoroughly in the OR.  Therefore they felt there was no need to put all the patients through the test.  Now if things are looking off they will do it but it is no longer standard for my surgeon.

Rebecca

Before my surgery, I asked my surgeon about this. He said that he does not do a barium swallow after surgery. His reasoning seemed profoundly logical to me:

He told me that if there is a leak, it neeeds to be surgically corrected. If surgically corrected right away, there is less chance of infection, etc. The best time to surgically correct a leak, he said, is during the initial surgery. Anything that requires a second surgery is risky and complicated. He uses a special dye on his patients after he has finished the procedure. He examines his work internally and looks for the special dye. If there is a leak, he'll find the leak right away and be able to fix it, before the patient is closed up. He also mentioned that he felt that a barium swallow was not an effective method of detecting a leak. HE said that there can be leaks that are not detected by the barium swallow. He implied that since he's used the dye during the initial surgery, he's had no leaks or problems whatsoever.

For the first 24 hours after surgery they had me on a monitoring device, checking my blood pressure and statistics frequently and automatically. After that they just checked fluid output etc. While I have a few negative things to say about my hospital stay overall, I felt like my surgeon was giving me the very best care. During the first couple of weeks I did have to call my surgeon for a few emergencies, and I was highly impressed with the fact that my surgeon or his partner was always on call for me.

It's not like it's a hard test - in terms of putting someone through it. It doesn't hurt; it's an easy test. You just swallow some liquid and they look at it on a screen to make sure where the contrast material is. The problem is that sometimes people with leak don't have all the classic symptoms. To me, this is poor care. I guess it's more of trying to save money at the expense of the patient. It's also not barium that you swallow, so it's different than an upper GI. Again, the problem is that you sending a patient home 1 or 2 days post op, where they haven't eaten in the hospital, and they may not be aware of the symptoms, or even have any way of checking them. Unfortunately, leaks don't always show up within a few hours of surgery.

Since my insurance was paying, I don't think they were trying to save me money. In truth I had popsicles within hours of being back in my room, and was "eating" (liquid meal) and drinking before they sent me home. They don't send anyone home until something makes it successfully through the digestive tract, even if it is only gas! They also sent me home with very specific instructions on what to look out for, pain, fever, tachycardia, nausea, etc. While I'm not sure that 'center of excellence" is that special a label, I did go to a center of excellence to have my surgery and went to one of the best bariatric surgeons in my state. As far as it being barium or not... since I never had one, I was just using the name that came to my mind. Whatever it is that they have you swallow, I'm glad I didn't have to do it, especially as walking was the one thing I couldn't tolerate the day of surgery (made me nauseas due to reaction to anaesthesia.)... having to do anything other than what I did do would have been difficult for me to handle.

I don't believe that's a fair assessment of why some doctors opt not to do a swallow test. My hospitalization was 3.5 days, which is the norm for my surgeon doing a lap RNY, and my care was stellar. I don't think he didn't do a swallow test to save money at my expense at all. I was on fluids for 2.5 days under their observation before I went home.

i had a swallow test the next morning but I know other surgeons just do the test in the operating room.

a lot of surgeons do an imaging test for leaks before you go to recovery.  So we don't have knowledge of the test.

My surgeon had me drink SF grape koolaide and NO red drinks, he said if there was a leak, it would show up in my drain (the purple fluid).

My surgeon doesn't do one. He has a drain in, and if that appears to be fine, then you are progressed to fluids. My other vitals were constantly being checked.