Question:
Does a revision that is not trasected work as well?

I got to see the surgeon this Last Tuesday, because I have had the old fashioned stapling in 1981 (22 yrs ago) The surgeon feels it is best to not transect the stomach but to make a small pouch and resection the Bowel, The surgeon has came highly recommended, I like him, and I trust him completely, But I am looking for anyone who has had this old type surgery in the past that has had the new RNY done. Did they do the transected? no? if not how has your weight loss been doing and how long has it been since it was done? I have promised myself that given this chance to have the surgery again that I will not do anything to jepordize it in anyway on purpose. I am just worried that if it didnt keep the first time it wont keep the second. Has anyone else dealt with this issue?    — LS F. (posted on September 5, 2003)

September 5, 2003
Just my personal opinion. If I was going through a 2nd surgery I would want as much assurance as possible that I would not end up with a staple line disruption in the future and transecting is the best way. Did he give you a good explanation as to why he does not want to transect? Does he normally transect when doing an RNY but because you are a revision, not transecting is the safest way? There would have to be really strong logical reasons for not doing it for me to agree. Do a search in the library under REVISION and I'm sure there are some in there doing exactly what you are doing. I've read some of them in the past but I just assumed when they got the RNY the 2nd time that they were transected, but I could be wrong.
   — zoedogcbr

September 5, 2003
I had the old surgery in 1981. I did not have stomach stapling but the intestional bypass which has since been outlawed because so many people died from amlnutrition and other problems. I had an emergency takedown of that last year to save my life. This year in feb, I had the "new RNY. I am transected because my surgeon said that for me this was the only way to go because of my previous problems with weight gain and he did not want to take a chance with non-transection and a staple line disruption. Which is possible if you are not transected.
   — Delores S.

September 6, 2003
I can't imagine haveing a revision and not being transected. May be he want to be able to do your 3rd surgery down the line. OK I have to admit I am predjudiced, I feel strongly that doing the surgery right the first time is important. The group I went with ALWAYS transects. They have a lot of long trem experience and this is what works long term. It is a scary thing knowing that your body is going to be so changed. I would rather do what ever is necessary to have a good long term success, there are a lot of surgeons out there, I would look a ttheir track record, amt patients lose, and amount they keep off. you have a lot to consider.
   — **willow**

September 6, 2003
My doc's been doing these since the 60's, so the good along with the bad models. Everyone I know who has revised from VBG to RNY earlier than 1996 (when he changed) was non-transected and has had to be revised again. I'd stick with transecting. Please be sure you will have enough bypass to do the job. Too short a bypass will put you back where you are in 5 yrs. That's pretty hard on a person. I can tell you for sure.
   — vitalady

September 7, 2003
As I have said on here many times and bet you are getting tired of hearing it, always be transected. I speak from experience and don't mean to sound harsh but unless you like to have surgery, doing it once with transection is the best bet. Plus the peace of mind that you have knowing that at least the pouch is permanent is really important. There are many things in WLS that can sabotage your success but as far as I know, transection is one that that can assure success at least in the area of staple line disruption. If your surgeon doesn't transect, I would find another. The surgeon will probably tell you that he does transect; however, for your own peace of mind, ask him. It is very wise of you to ask this question prior to having the revision instead of after, as many people do not ask ahead of time. If the surgeon still feels it is best not to transect, perhaps you could ask why and if his reasoning is sound, it is your choice to go ahead trusting his decision. He probably has a good reason not to transect and if so, at least you will know why he didn't transect and have better peace of mind with your decision. God bless,
   — Mylou52

October 7, 2003
I am having a revision from a vbg to a rny tomorrow! My dr says that he usually will not transect, due to it causing motility. I do beleive him, he is a very safe dr and I have been reading some posts and there are some people that have motility. Some of them even have to sleep sitting up. One girl said that when she bends down to pick up her child, she vomits. Each surgeon has his/her reasons for why they do and do not transect. As long as there is no staple line distruption, things should be ok! Just another opinion.~Diana
   — [Deactivated Member]

October 7, 2003
I am having a revision from a vbg to a rny tomorrow! My dr says that he usually will not transect, due to it causing motility. I do beleive him, he is a very safe dr and I have been reading some posts and there are some people that have motility. Some of them even have to sleep sitting up. One girl said that when she bends down to pick up her child, she vomits. Each surgeon has his/her reasons for why they do and do not transect. As long as there is no staple line distruption, things should be ok! Just another opinion.~Diana
   — [Deactivated Member]

October 7, 2003
Yes, I agree with the others who have been there, done that...go for the transection. Staple line disruptions don't "always" happen, but they happen often enough not to risk yet another surgery.
   — Leslie F.