More questions..blind stomach?
I have no idea what anyone would mean by a "blind stomach". It is not a usual term with the sleeve. There is no such thing as a "blind stomach", that would mean a stomach that is not attached. With the VSG, the part of the stomach that is no longer used is removed from the body, so there is nothing "blind" left.
You do have a large portion of the stomach that is not used, and is not hooked up to the intestines, with the RnY. Perhaps that is what they mean by a "blind stomach".
The Pylorus is a valve at the far end of the stomach, that regulates the flow of pre-digested foods into the intestine. With bypass surgery, the pylorus is bypassed, so any food eaten is dumped directly into the intestines. This is why they get "dumping syndrome", because there is no real stomach to pre-digest the food, and it hits a part of the intestines that were never intended to deal with food in that state.
With the VSG, the pylorus is 100% intact. Food will be slowly released into the intestine, at a normal rate. It has not been completely "pre-digested", but at least some pre-digestion has happened. (That's why they do not want you to drink with eating. Fluids hurry the food through the remaining stomach.) Your intestines can handle that, and there is no real "dumping syndrome" possible with the sleeve.
Now, some people are still VERY sensitive to sugars, especially at first. They may welll feel horrible after eating sugary foods, and they may thrown up, feel clammy, etc. While this may be somewhat similar to actual "dumping, it is NOT the same thing at all.
You do have a large portion of the stomach that is not used, and is not hooked up to the intestines, with the RnY. Perhaps that is what they mean by a "blind stomach".
The Pylorus is a valve at the far end of the stomach, that regulates the flow of pre-digested foods into the intestine. With bypass surgery, the pylorus is bypassed, so any food eaten is dumped directly into the intestines. This is why they get "dumping syndrome", because there is no real stomach to pre-digest the food, and it hits a part of the intestines that were never intended to deal with food in that state.
With the VSG, the pylorus is 100% intact. Food will be slowly released into the intestine, at a normal rate. It has not been completely "pre-digested", but at least some pre-digestion has happened. (That's why they do not want you to drink with eating. Fluids hurry the food through the remaining stomach.) Your intestines can handle that, and there is no real "dumping syndrome" possible with the sleeve.
Now, some people are still VERY sensitive to sugars, especially at first. They may welll feel horrible after eating sugary foods, and they may thrown up, feel clammy, etc. While this may be somewhat similar to actual "dumping, it is NOT the same thing at all.
A former Army Medic (1959-1969), Registered Nurse (1969-2000), College Instructor (1984-1989) and a retired Rehabilitation Counselor. I am also a dual citizen of the USA and Canada.
High Weight 412 lbs. Date of Surgery 360.5 Present 170 lbs
High Weight 412 lbs. Date of Surgery 360.5 Present 170 lbs
Thanks Medic! I have been wondering about this. I never really understood what dumping syndrome was either. I'm gonna bookmark you!
Erica H. 
http://dramaqueensguide.blogspot.com
"We go through what we go through to help others get through what they go through."
http://dramaqueensguide.blogspot.com
"We go through what we go through to help others get through what they go through."
Actually with the RNY the stomach is attached to the intestines, that makes up one half of the "Y". I believe the term blind stomach is referring to the fact that the remaining stomach can no longer be accessed via the esophagus which means it can not be explored via an endescope. The fear some people have is that ulcers or gastric cancer would be harder to detect in a "blind" stomach.
With the RNY, the portion of the stomach left after the surgeon makes the pouch, as well as the upper small intestine, remain - they are just bypassed, not removed. It's referred to as a blind stomach because it cannot be scoped -- there is no way to get a camera in there. The stomach remnant can still develop ulcers (or cancer for that matter) but there is no way to examine it.
The pyloric valve connects the stomach and the small intestine, and regulates how quickly food moves from the stomach into the intestine. In VSG surgery, it is left intact -- only the greater curve of the stomach is removed, keeping intact the valves at both the top and bottom of the stomach. In RNY, the pylorus valve is bypassed. The surgeon constructs a pouch and a "stoma" in place of the valve --but of course, it doesn't function as well (or at all, really.) When someone with RNY "dumps" it is because sugar moves too quickly from the stomach into the small intestine, creating a sick feeling and a bathroom emergency. Since sleevesters have their pylorus valve, this doesn't happen.
Have you gone to a seminar yet? They usually explain this with diagrams etc. It can be confusing without visual aids!
MM
The pyloric valve connects the stomach and the small intestine, and regulates how quickly food moves from the stomach into the intestine. In VSG surgery, it is left intact -- only the greater curve of the stomach is removed, keeping intact the valves at both the top and bottom of the stomach. In RNY, the pylorus valve is bypassed. The surgeon constructs a pouch and a "stoma" in place of the valve --but of course, it doesn't function as well (or at all, really.) When someone with RNY "dumps" it is because sugar moves too quickly from the stomach into the small intestine, creating a sick feeling and a bathroom emergency. Since sleevesters have their pylorus valve, this doesn't happen.
Have you gone to a seminar yet? They usually explain this with diagrams etc. It can be confusing without visual aids!
MM
Aloha Pengworm-
Please look at the diagrams of the stomach and intestines for an RNY vs a VSG when reading these explanations, it's far easier to visualize.
The other posters are correct- in an RNY, the stomach is divided into two separate compartments- the gastric "pouch" where the esophagus and all food enters, and the blind or "bypassed" stomach which leads to the bypassed portion of intestines. This bypassed/blind stomach is a dead end sack which cannot be entered via the esophagus with any scope or tube- it means you cannot visualize its interior later even if you tried to pass the scope through the esophagus to gastric pouch through stoma to distal small intestine and try to get back up the end of the bypassed intestine- it's impossible to manuever the scope in that manner. The pylorus is no longer the exit to your functioning gastric pouch, but rather the exit to the bypassed/blind stomach. This bypassed stomach still produces gastric juices and grehlin, but does not handle any food. Those digestive juices travel down upper bypassed portion of the small intestine and meet up with the nutrients from the other limb ( forming the "Y").
In a VSG, you have your esophagus leading to your (smaller, narrower) new sleeved stomach and a normal exit through the pylorus, which is exactly the path nature intended your nutrients to travel. You are missing about 75-80% of your stomach (the fundus) where most of the grehlin is produced- it's why most VSGers lose their hunger. If you need to see the inside of your sleeve, it can still be visualized with a scope passed down your esophagus ( sometimes there is a need to look for ulcers, neoplasia, or other pathology).
One of the problems with the "stoma" or new opening of an RNY vs the pylorus is that the stoma can styretch out- effectively this means food empties more rapidly from your pouch in an RNY and you lose some of your restriction ( you don;t feel as full for as long). Read the revisions board, posters there talk of doing procedures such as Stomaphyx or ROSE to make that stoma small again. Your pylorus, on the other hand , will not stretch out. Your sleeve can stretch some, but most of the "stretchy" portion is the part that's been removed ( the fundus or greater curvature) leaving the more tough muscular lesser curvature intact.
Hope this helps- and your surgeon's office should be explaining this to you so you understand FULLY ( you're probably in the researching phase and haven't yet had that opportunity!).
Be well- XOXOLori
Please look at the diagrams of the stomach and intestines for an RNY vs a VSG when reading these explanations, it's far easier to visualize.
The other posters are correct- in an RNY, the stomach is divided into two separate compartments- the gastric "pouch" where the esophagus and all food enters, and the blind or "bypassed" stomach which leads to the bypassed portion of intestines. This bypassed/blind stomach is a dead end sack which cannot be entered via the esophagus with any scope or tube- it means you cannot visualize its interior later even if you tried to pass the scope through the esophagus to gastric pouch through stoma to distal small intestine and try to get back up the end of the bypassed intestine- it's impossible to manuever the scope in that manner. The pylorus is no longer the exit to your functioning gastric pouch, but rather the exit to the bypassed/blind stomach. This bypassed stomach still produces gastric juices and grehlin, but does not handle any food. Those digestive juices travel down upper bypassed portion of the small intestine and meet up with the nutrients from the other limb ( forming the "Y").
In a VSG, you have your esophagus leading to your (smaller, narrower) new sleeved stomach and a normal exit through the pylorus, which is exactly the path nature intended your nutrients to travel. You are missing about 75-80% of your stomach (the fundus) where most of the grehlin is produced- it's why most VSGers lose their hunger. If you need to see the inside of your sleeve, it can still be visualized with a scope passed down your esophagus ( sometimes there is a need to look for ulcers, neoplasia, or other pathology).
One of the problems with the "stoma" or new opening of an RNY vs the pylorus is that the stoma can styretch out- effectively this means food empties more rapidly from your pouch in an RNY and you lose some of your restriction ( you don;t feel as full for as long). Read the revisions board, posters there talk of doing procedures such as Stomaphyx or ROSE to make that stoma small again. Your pylorus, on the other hand , will not stretch out. Your sleeve can stretch some, but most of the "stretchy" portion is the part that's been removed ( the fundus or greater curvature) leaving the more tough muscular lesser curvature intact.
Hope this helps- and your surgeon's office should be explaining this to you so you understand FULLY ( you're probably in the researching phase and haven't yet had that opportunity!).
Be well- XOXOLori
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