Question:
At 9 mos post I have a staple line disruption. I had open rny but I was not

transected. I had an upper GI and it was distressing to see that barium leak over the top of my pouch into the old stomach. Oh my. I have to start all over again, but my pouch is still small and I haven't gained any yet. I knew the last 10 lbs were sooooooo hard to lose. I didn't really believe I had disrupted but I sure did. It is a tiny opening at the top of the pouch. I still can't eat very much. Although I am scared, I can't wait to have this fixed and start losing again. My question: Please anyone who has had this happen, is it easier the second time? I posted this question last week but it got lost. I need encouragement so badly. Is the incision the second time as big as the first time? All the routing of the intestine, etc is still there so I think all that needs to be done is the cutting apart of the pouch and the old stomach. I would NOT have rny without transection as a word of advise to you guys. When I had it 9 mos ago, I had no choice but now my surgeon DOES transect. I have BC/BS Federal insurance with BC/BS of Illinois as a secondary. Do you think this will be covered? Thank you all and God bless America. I learned about this on the very day of the terrorist attacks. It has been a horrible week. My problem seems trivial compared to what others have faced this week. Thank you for any advice on this.    — Marilyn C. (posted on September 14, 2001)

September 14, 2001
Im so sorry to hear what has happened to you. Do you know what caused it to occur? I wish you all the best and a quick and speedy recovery with your revision....
   — Melissa S.

September 14, 2001
My revision was uneventful. Still is an annoying abdominal surgery, but other than normal soreness & recovery, it was not a big deal. Being much lighter & without comorbs helped a lot. They did not change my surgery type, but just repaired the pouch, as you are expecting. As we have discussed many times, I'm just making sure that you know this is not a "fault" thing. Some bodies just reject the changes we have tried to make, much as bodies will try to reject organs or man-made life saving parts. That's really what they are SUPPOSED to do: REPEL THE INVADERS! So, I'm just reminding you that this is a flat tire, mechanical failure. Right?
   — vitalady

September 14, 2001
My original RNY open, and my revision was done lap. There was a huge difference in recovery time. The day after I was released from the hospital after my lap transection, I was shopping at the mall. Don't forget, even if your revision is done open, you'll be much thinner and healthier, you know what to expect post-op about eating, and it's especially easier because you know that there is life after WLS. Good luck!
   — Leslie F.

September 14, 2001
Melissa, thanks to you for your support. And to everybody else too. To answer your question, no I did not have any symptoms of disruption other than slow wt loss. I can still only eat about a cup at a time which is normal. I just saw others losing so much faster and asked for an upper GI to see if all was intact. I followed instructions 100% but as someone else explained on here (and I asked my surgeon if it was true and he said YES).....when the pouch is not transected (cut/separated physically) from the old stomach, the mucuous edges of the two surfaces (the new pouch and the old stomach) will never form scar tissue. It just does not happen. Some people still never disrupt, but some do sooner or later. When the pouch is physically cut away from the stomach, the pouch is still stapled and oversewn and in a short while, scar tissue forms a tight seal. We all have staples but the transected ones, form scar tissue. The risk of a leak post op is slightly higher in transection but it usually occurs in the first few days after surgery and is addressed immediately. If the staple line disrupts with transection, the food can enter the body and cause peritonitis which is dangerous. But once again, if this happens while you are still in the hospital, hopefully it can be repaired immediately. That is why some surgeons do the leak test while you are in the hospital. At the time I had my surgery my surgeon did not transect because he felt it was unsafe. Since then he has joined the majority of surgeons doing the open rny that do transect because the chance of disruption after healing is nil. Although I hoped I would be lucky and not disrupt, I did disrupt. MIchelle Curran explains it so well....it is a mechanical failure and not anything we did wrong. I have learned a lot in 9 mos now I would not have this surgery without transection. I just hope I can get through another surgery. I am really scared again.
   — Marilyn C.

October 10, 2001
hi marilyn i was wondering how you KNEW you had a staple line disruption. I know you are only 6 mos post op. Can you tell me what your symptoms were? Were you sick at all? I can eat lots of food and am thinking maybe my staple line is disrupted but am wondering how you knew to ask for an Upper GI. thanks'] Bonnie
   — [Anonymous]

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