Headed to Mexico...
Please be careful and here is some questions to ask and things to think about in regards to VSG surgery. I would ask how much experience he has and where he starts the stapling line from the pylorus also about keeping away from antrum. Ask if he does any reinforcing of staple line. Good luck!
Because the procedure—performed laparoscopically with linear staples—is relatively simple, there is little room for variation in approach and technique. Results from a questionnaire filled out by surgeons at the First International Consensus Summit for Sleeve Gastrectomy in New York, in 2007, showed that most surgeons start stapling 5.5 cm from the pylorus. "Very few people go any closer to the pylorus. It seems to create more vomiting, dysphagia, prolonged nausea," Dr. Gagner said. "By staying away from the antrum we seem to avoid some of those complications."
Surgeons do vary a bit in preference for size of the bougie-32 to 40 French—used to create the sleeve. Another variation is in the choice of reinforcement if any—along the staple line in an attempt to reduce bleeding and leaks, the two common complications of the operation.
"Leaks that occur very close to the esophagus seem to be in the range of 1% to 2%, and lower leaks along the staple line occur less frequently, maybe 0.5%," Dr. Gagner said. Bleeding occurs in about 1% to 2% of patients. "We cannot make a claim that use of buttressing material reduces leaks, but there have been three or four publications showing that this material reduces bleeding."
To reinforce the staple line, some surgeons use bovine pericardium; some, such as Dr. Szomstein, oversew with sutures. "We feel that this reinforcement is the most economic and efficient option," Dr. Szomstein said. "Some people don't use [any reinforcement] and it is still fine. There is no standard of care in that regard."
Although there is no clear-cut indication for the sleeve, it may be suitable for most patients who meet National Institutes of Health criteria for any bariatric surgery
Because the procedure—performed laparoscopically with linear staples—is relatively simple, there is little room for variation in approach and technique. Results from a questionnaire filled out by surgeons at the First International Consensus Summit for Sleeve Gastrectomy in New York, in 2007, showed that most surgeons start stapling 5.5 cm from the pylorus. "Very few people go any closer to the pylorus. It seems to create more vomiting, dysphagia, prolonged nausea," Dr. Gagner said. "By staying away from the antrum we seem to avoid some of those complications."
Surgeons do vary a bit in preference for size of the bougie-32 to 40 French—used to create the sleeve. Another variation is in the choice of reinforcement if any—along the staple line in an attempt to reduce bleeding and leaks, the two common complications of the operation.
"Leaks that occur very close to the esophagus seem to be in the range of 1% to 2%, and lower leaks along the staple line occur less frequently, maybe 0.5%," Dr. Gagner said. Bleeding occurs in about 1% to 2% of patients. "We cannot make a claim that use of buttressing material reduces leaks, but there have been three or four publications showing that this material reduces bleeding."
To reinforce the staple line, some surgeons use bovine pericardium; some, such as Dr. Szomstein, oversew with sutures. "We feel that this reinforcement is the most economic and efficient option," Dr. Szomstein said. "Some people don't use [any reinforcement] and it is still fine. There is no standard of care in that regard."
Although there is no clear-cut indication for the sleeve, it may be suitable for most patients who meet National Institutes of Health criteria for any bariatric surgery
Thank you for the well wishes. Good luck to all of you as well!! This forum has meant a lot to me in this past month even though I don't post often, I feel connected to everyone who shares their story. It has given me hope and assurance that things will get better!!!! Here's to a healthier life for everyone! 
Most Active
Recent Topics
