Question:
Transection vs Staple Line?

I am less than one month away from my scheduled surgery date. Suddenly I am contemplating switching doctors. The primary reason is that my present surgeon does not do transection, he simply does staple line. The more information I gather, the more convinced I am that transection is the better way to go and presents much fewer post op complications. Of course, switching doctors also means I'm starting almost from scratch and pushing my surgery back. Any thoughts on which surgery is the best way to go?    — Martha K. (posted on March 15, 2003)


March 15, 2003
thats not nessacarily true that transection means less problems..a staple line yes can disrupt but it doesnt happen to everyone u only hear mostly bad stories about the ones that did..my DR doesnt transect and none of his 100 or so patients have disrupted and im doin great 2 months out and no complications..why be cut more then u hafta be..just my opinion tho :)
   — christine S.

March 15, 2003
I had staples with another surgery...other then having a drain in for 24 hours, it was a breeze. 1 week later they took the staples out...no problems. Nothing opened back up...and now there is ZERO and I mean ZERO scar...not even a discoloration.
   — Renee B.

March 15, 2003
Been there, done that...go with the transection. I found out about my SLD at about 6 months out, but many don't find out for over 5 years or when they start gaining weight back. My original open RNY was 8/99, and I was able to be transected laparoscopically on 8/00, and now all is well. I was extremely fortunate that my insurance approved the transection, too, because at that time my BMI was down to 35. So, if it should happen, it not only would involve another surgery, but there may be a problem getting insurance approval down the line. JMHO.
   — Leslie F.

March 15, 2003
have you had your consultation with the surgeon and asked why he/she does not transect and that you have concerns? i had some concerns about other issues about my surgery and was unable to see the surgeon about it since i lived out of town from where i had my wls. i talked to my local/very wls supportive pcp. he put my mind at ease and and helped me make the final decision on what surgeon to use. so i would also suggest you talk to a trusted medical person who of course is wls friendly. my other comment is, insurance wise you probably wouldnt have to "start over" and depending on what dr you change to, if you explain the situation, maybe you wont have to wait as long. i know someone who changed surgeons and it didnt set their wait back that much cause insurance issues were already handled. my own experience with my rny is that it is transected and i personally feel that it is the best way to go. my sister had her surgery 5 yrs before me and was part of a study on whether to transect or not transect. she was not transected. the interesting thing to me is that although she has personnally not had any problems, her surgeon now only does the transected procedure based on the study that he did. bottom line is go with what you will be at peace with. good luck. patsy in las vegas
   — PATSY N.

March 15, 2003
Personally, I would go with the surgeon who transects. I know it will be frustrating to switch surgeons, and then ofcourse have to wait AGAIN. But although SLD's are small percentage, they are pretty common. There are quite a few people on this site who were stapled, then had SLD, then had revision and got transected. If you can avoid any possibility of a complication, I would go for it. I was LAP RNY transected 9 months ago. Goodluck to you and glad you did your research! :)
   — Lezlie Y.

March 15, 2003
I'm a Stapled. The surgeon explained the reason why they staple instead of transection. The reason is that stappled are easier to reverse if need be. It's just a matter of removing all the staples whereas a transected stomache must be sewn back together. As for my own opinion... if there is a leak in the pouch I'd rather it go into my larger stomache then leak into my abdominal cavity causing infection etc.. <p> Take Care, Be Well, Be Happy!!
   — John T.

March 15, 2003
While what John says is true- a stapled line is easier to reverse- the stomach is an icredibly strong muscle and will do ANYTHING
   — ~~Stacie~~

March 15, 2003
While what John says is true- a stapled line is easier to reverse- the stomach is an icredibly strong muscle and will do ANYTHING
   — ~~Stacie~~

March 15, 2003
While what John says is true- a stapled line is easier to reverse- the stomach is an icredibly strong muscle and will do ANYTHING to be whole again- the is why many surgeons transect now. Mine transects, staples and then surtures over the staples.
   — ~~Stacie~~

March 15, 2003
I've had both. SLD at 5 yrs, when it "can't happen", statisically. So, I got to start over for the revision. Same, same. The fear of ins not paying, fear of 100% + regain......... had to go thru it twice. Given a choice, I would transect the first time around.
   — vitalady

March 15, 2003
I'm transected, each piece staples closed and then all staples oversewn. I feel most safe with this procedure. Changing doctor's will delay your surgery but it should not have to be a really long time if you tell the new doctor's office you have all approvals and tests done. That should move you way up the list.
   — zoedogcbr

March 15, 2003
If you have any doubts, I say it is better to possibly delay for a little while than to have a procedure that might not be right for you, How would you feel if you have to have a revision? be very very comfortable with the procedure you choose to have. This is for a lifetime.
   — **willow**

March 15, 2003
If you have any doubts, I say it is better to possibly delay for a little while than to have a procedure that might not be right for you, How would you feel if you have to have a revision? be very very comfortable with the procedure you choose to have. This is for a lifetime.
   — **willow**

March 15, 2003
Personally, I wouldn't have had it done if I wasn't transected...Good luck!....Karen (lap rny- almost 6 mons. post- down 118 pounds!)
   — karmiausnic

March 15, 2003
Happily, I had no choice but to be transected, which is what I wanted. I had lap RNY and the surgeon said the openings he makes won't allow for a stapler. I also knew going in that this was going to be a permanent, life changing surgery, so transection was just fine - never gave any thought to having a reversal for any reason in the future. However, when the surgeon does do stapling, be aware it is not just one little row of staples. I think it is about 5-7 rows and most oversew also, so it's pretty darned sturdy and most people don't have problems with disruption. I think if you are comfotable with your surgeon, go with it, but if you have doubts, see another surgeon for consultation. You need to be completely confident about what you are going to have done.
   — koogy

March 16, 2003
Transection without any hesitation on my part. Read my profiles Marilyn Childers (before transection and with SLD) and Marilyn Childers Part Two (after revision to transection)....pretty indepth and read for yourself the frustration that occurs with staple line disruption. I would not have WLS without transection unless you want the possibility of having to be "redone" sometime in the future. Just for the record, overeating does not make the staples come undone. It is just the mechanical failure of nontransection....I compare it to leaving a ink pen uncapped on your silk bedspread, perhaps it won't leak onto your silk bedspread but someday, somehow, it probably will.
   — Mylou52




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