Question:
I had hoped for a RNY transected surgery, but my surgeon says it is safer for him to

I had hoped to have an RNY transected, but my surgeon feels it would be safer for me not to have the transection. He says he will be using 3 rows of staples, plus clamps at both ends. I guess I thought that having the pouch transected would mean absolutely permanent. Now I am worried that somehow the staple line could become disrupted and I might regain weight. The Dr. says if a staple line disrupts, it will happen whether it is transected or not and the biggest cause is overeating or not following instructions and stretching the pouch, causing too much stress at the staple lines. Can anyone with an un-transected RNY give me some background on this?    — Raulene C. (posted on November 12, 2001)

November 12, 2001
Raulene, that information is contradictory to what my surgeon told me. I am transected and really glad about it! He told us that it doesn't matter how many rows of staples are put into the stomach to create the pouch. Those tissues are mucous membranes and will never grow together and form scar tissue. Consequently, in some people, there is that tendency for the staples to work themselves loose. When you are transected the pouch is created by bringing the correct edges of the stomach together and stapled and in my case, oversewn. This DOES form scar tissue and is much less apt to disrupt. If there is a disruption, it would be early post op, before that scar tissue is formed. With a pouch that is only stapled, the risk of disruption is forever. I would definitely keep researching this aspect of your surgery. Many people have "settled" for a nontransected pouch, only to be back in surgery having a transected pouch created. Hope this helps. Research, research, research...
   — Shelley.

November 12, 2001
Hi, Shelley is absolutely correct in this. It happened to me! I did not overeat, I lost 68 lbs and didn't regain any, my pouch was not stretched at all. Still, after 6 mos my staple line came undone. I had a partial disruption and I had 8 rows of staples! I went back to be transected a month ago and I am doing fine now. No more staple line disruption. Your doctor is not being truthful by saying if it is going to disrupt it will when transected too. Or maybe he is just not comfortable transecting the stomach. Most skilled surgeons are now transecting. Many people have had the stapling alone as I had done first and have not disrupted. Many have quit losing and did not know why. The disruption does not cause any pain when it happens with a non transected pouch. You simply just can eat more! Lots of people quit losing or regain and then state "this surgery doesn't work" when it is a mechanical, fixable problem with the staple line disrupting. For me, I would not recommend having rny without transection. I knew when I had it done the first time I wanted transection but as with you, my surgeon just didn't do it at the time. He started transecting a few months later,however. Somehow, I had hoped that regardless I would be lucky and not disrupt. Well, I followed all the rules 100% and still disrupted. I am now down 80 lbs and quite honestly, I am glad I am transected now. I can relax because I know it is permanent. Good luck to you in whatever you decide. In my humble opinion though, I would try to find a doctor who transects and you won't have to go through two surgeries as I had to.
   — Marilyn C.