Question:
I am having a open RNY(non-transected) on 10/11/02...

On the flip side of the previous question how are people doing with that ..I feel confident on why I chose this method ..just want to hear from others on how they are doing    — Anne B. (posted on September 19, 2002)


September 19, 2002
Hi Anne. Why non-transected? Just curious. I'm post-op open RNY -- now almost 9 months out. I've lost a bit over 100 pounds now -- it's been slow the past couple of months. Seems like the inches are still rolling off but the pounds are moving a bit slower. I am transected though. My surgeon felt that the risk of staple line disruption is too great not to transect his patients. I've had no complications from this procedure. I've had multiple episodes of dumping and nausea -- all 100% self-induced. I'm still learning what my body will and won't tolerate. But all things considered, this is the second best thing that ever happened to me (the first is my dh and kids!). Best of luck with your surgery.
   — Pam S.

September 19, 2002
hi there i had open rny on feb 8 02 im now down over 140 lbs since then. im 5 9 and came down from 370lbs so needless to say im feeling great and as light as a feather! :) i too am not transected and to be honest, with as much research as i thought i had done. i had never heard of this. after i was post op i discovered the difference between the two and was a little scared that i had not been trandsected. i talked to my surgeon about this and he had assured me that as of yet he had not had any stapelelind disruptions. i had read that they both have there pros and cons. to be transected meant youd never have a stapleline disruption but if you wer to leak it could lead to paeritinitus(spelled wrong) which if not caught is fatal but this usually occurs while you are still very new post op.to not be transected meant to possilby have a staple line disruption in the future,not fatal but gaining wieght back was inevitable. this does scare me and i hope it never happens. so far so good and im very greatful!best of luck to you!
   — carrie M.

September 19, 2002
I also had an open RNY (non-transected) on 7/17. I am down 78 pounds in the two months since the operation. As far as the transected vs. non-transected, this is usually not the choice of the patient. It is up to the surgeon. I asked my surgeon (Dr. Raper) about this: "It is very unusual for the staple line to breakdown, and usually occurs in people who chronically stuff the pouch with excessive amounts of food. The reported incidence of staple line disruption I quoted you initially is 1-3%, but this is for both the intra-abdominal leak as well as the re-opening of the pouch." <p> You'll find a lot of posters on here touting the transected vs. non-transected, but as I said above, this is determined by the surgeon - not the patient. Be confident that your surgeon is using the technique that he feels is the best for his patients...JR (open RNY 07/17 -78 lbs)
   — John Rushton

September 19, 2002
With my research... I decide that I'd go with the surgeon I wanted.. and he doesn't transect. For me, that's fine. I sometimes think there is a vocal minority around here that touts things that they thing are right.. just like types of surgeries.. this site is mostly about Rnys.. but there are other things out there. I'm fine with what I have.. you can have a disruption of staples.. transected or not.. they can fail.. I'd rather gain weight than get sick and die. There.. how's that for what's good about not being transected?
   — Lisa C.

September 19, 2002
Hi John I beg to differ with your surgeon. I had a SLD and I never ever stuffed myself. I lost 68 lbs with my first non transected rny and thought all was well, until the weight became almost impossible to lose. It took me 3 mos to lose 10 lbs with the SLD. I don't think this is a controversial issue or that we, who are transected think it is the only way. Like you said, it is up to your surgeon. I was one of the 1-3% that disrupts unfortunately. It was not my fault though. I think that many more people have SLD later in life when they regain the weight and don't know it. They just think "this WLS doesn't work for me". Thank goodness I found out right away what was wrong and had it fixed by transection. Now I do feel confident that this small pouch is forever. I hope no one disrupts but please, don't blame the person. It is a mechanical failure and comes from the rejection of the staples and failure of the tissue in the stomach to form a tight seal. With transection, the scar tissue forms quicker and the pouch hopefully seals permanently. No argument here about whether transection is better than nontransection but if given a choice, I would chose transection. -110 lbs and on the way to goal! Marilyn in WV
   — Mylou52

September 19, 2002
Hi Anne, Funny you should raise this issue. I am scheduled for open rny 9/26 and I emailed my doc. yesterday inquiring about transection and just assuming that he does them. He doesn't and his reason is that transection increases the risk of a leak and that the chances of 8 rows of staples breaking down is very remote. I was surprised by this but I'm going to go ahead as planned because I have confidence in this doctor. I will hope for the best. Good luck and best wishes to you.
   — kelleykeith

September 19, 2002
The stomach typically rejects the staples because they are not recognized by the body, and considered a 'foreign body'. The breakdown is not usually from pushing food volume, but I'm sure that can also contribute to SLD. They started transecting because of the common problem of SLD. Leaks are very uncommon and are caught while still in the hospital. There are those who do have success, so maybe you will be one of those. I know Michelle Curran could probably give you some advice on this subject, she had to go back for more surgery. 10 mo. post-op, 9 lbs. to goal, transected and still living!
   — Cheri M.

September 19, 2002
Since I've had both, I'd take transected any day. I was lucky that mine didn't go til the 5th year. That was the first time we'd had good insurance in all that time. I'd have been SOL if it'd happened sooner. Of our peer group (done 1994-1995) there were 2 left after me. My almost-surgery-sister didn't "go" til this year (7.5 yrs). My husband is the last one in our original group who is still intact at 7 yrs. He did have a post-op leak (immediately), life threatening, but at the stoma. Even so, he would do it again, but transected. AND we live, waiting for the day his staple line goes. He's not as careful as I am about his regimen and we both have no doubt that he could regain his wt and his comorbs in a few short months. We don't necessarily trust the insurance he has today, either. Yes, I feel very strongly about this as I've seen SLD destroy lives & marriages, as the victim blames herself or the doc or the family, or simply retreats from life. Each person makes their own choice based on the info available at the time. Back in the early 90's, transection was not offered to us. Probably would've scared us at our level of understanding then. But since you asked for opinions, there's mine. 2 surgeries when one woulda done it, had I been done in 1996 (when my doc changed).
   — vitalady

September 19, 2002
My surgeon did not transect and I got a SLD at 1 year post op. I was at my goal weight of 120lbs, so I obviously wasn't 'overstuffing my pouch.' I was just one of the 1-3% it occurs in. I couldn't run to the Operating Room fast enough to be transected. I know a lot of non-transected RNYs have no complications. But the fact is, mechanical failures happen.
   — Maureen S.

September 20, 2002
I am transected and did develope a small abdominal leak. It was nasty at the time, and required more hospital stay. It was not caught during my initial stay and required readmittance. Despite it being a very trying time for me, a year later and a whole new life at my heals, I'd do transected again....in a heartbeat. -Kim open RNY 7/17 -130lbs
   — KimBo36

September 20, 2002
Just to let you know, I had 8 rows of staples too and still disrupted. The pouch was still closed at the bottom but had an opening at the top. AND my pouch was not stretched at all. If I had been eating too much, it would have stretched. When I had an upper GI the barium filled up the tiny pouch and then flowed into the old still attached stomach. It was strange to see. AND I had a leak test at the hospital immediately after the surgery. I think it disrupted at about 6 mos postop. Had my revision 11 mos postop and what a difference that made. I did not hesitate to be transected and had virtually no problems the second time. Healed quicker and also my scar was made prettier. Good luck with your nontransected surgery. I hope you are one of the people that have a lasting staple line. Two surgeries in one year is not fun.
   — Mylou52




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