Question:
I'm up for revision this Tue, feeling confused and afraid, can U-HELP???

2.5 yr post-op RNY. Due to a stapleline disruption and ulcers in my pouch, my doc wants to do a complete restaple and transection this Tuesday, can you help me to understan why the transection since it's high risk for leakage, infections and possible long term complications? Wouldn't it be easier & less risky if he just repaired the hole and treated the ulcers?? The hole is about 5-6 mm in size, I haven't a clue how big or small this is, I'm guessing it can't be much bigger than pea size. I'm feeling afraid, not afraid of dying, but afraid of the unknown, I don't want to be troubled with continued complications down the line. I have the pre-surgery jitters and am so confused. I don't want to make the wrong choice, I feel like I'm dammed if I do and dammed if I don't. All comments appreciated. God Bless    — Barbara M. (posted on November 29, 2003)

November 29, 2003
Im sure you trust your doctor. And you answered your own question... "I dont want to be troubled with continued complications' By doing a little more now (the transection) he's doing just that... You cant have staple line distruption.. if your transected. You'll do fine. You already know what to expect.... your part is the same as last time :) you'll do fine.... good luck
   — star .

November 29, 2003
Are you afraid of the surgery itself? The immediate after? Life after? Transection in general? I'm not quite sure where your fear is, exactly. You're wondering why you have to be transected and they can't just patch the hole? The patches don't hold. You'd be facing revision within the year if you patched. My life is SO MUCH BETTER since revision. 5-6mm is maybe pinky size? Something like that. TODAY. If your whole staple line unzips...........
   — vitalady

November 29, 2003
Barbara, If it was me facing the revision the only way I would allow the doc to do it would be with a transection. That is how 99.9% are done today as that's the most proven for NOT having problems. The stomach is left in there in case something bizarre happened and you needed it in the future. <p>I'm not sure where you found that transection puts a person at high risk for leakage and infections and long term complications as with all the reading and online groups I am on, I have not found that to be typical or true. My surgeon not only transects and staples but then oversews all of the staples for extra assurance. The more typical place a leakage can occur is at the reconnection point of the small intestine. Leakage at the transection line is very rare and normall happens early on. My surgeon also fills the abdomen with saline and pressurizes the pouch before closing to look for any leaks. Then does the leak test the next day. Developing a leak 2-1/2 years out with a transection is pretty rare. Much less rare than when a person is not transected. <p>2.54 centimeters is an inch, therefore 25.4 mm is an inch. So 5-6 mm is pretty small, but still dangerous. <p>Sounds to me like your surgeon has your best long term interest at heart. Maybe you need to be having a heart-to-heart with him or her tomorrow so that you fully understand why it's necessary to do the surgery this way. Good luck on Tuesday and I'll be thinking of you!
   — zoedogcbr

November 30, 2003
Barabra, I am so sorry you are having to go through this.Before you have this done it seems like you need to sit down and have a heart to heart with your Dr. With surgery this close you shouldn't still have so many unanswered questions it doesn't seem like he went into a lot of detail as to what happened to you and why he has chosen to repair it this way you should know everything you can before you have this done. Good luck
   — Lisa F.

November 30, 2003
Chris D. is right on the money in the analysis of why being transected is the preferred form of the RNY. Two people in my support group have been revised the past year--- both had been originally operated years ago by different surgeons and neither had been transected. Both have had great results since their revisions. Good luck.
   — SteveColarossi

November 30, 2003
Hi- My thoughts are with you. I had my surgery in April of 1997. I now need a revision as well for the same reasons you have listed. My staple line broke, I have gastric ulcers, and Barretts. I feel the same way you do. I think I am more frightened by the risk of surgery. The one thing I am learning is how important it is for you to advocate for yourself. It look 9 months before anyone really took me seriously. I just had a baby and gained weight. It is important to listen to your body and advocate for what you need. You are worth it!! I know this is hard for me. I also don't want to live with the complications either. Trust your gut,head, and heart have all your questions answered even if you have to ask them again. In my orginal surgery my stomach was not transected. Maybe you will be feeling so much better. That is my hope. My thought are with you. Sherry
   — sherry K.

November 30, 2003
Hi- My thoughts are with you. I had my surgery in April of 1997. I now need a revision as well for the same reasons you have listed. My staple line broke, I have gastric ulcers, and Barretts. I feel the same way you do. I think I am more frightened by the risk of surgery. The one thing I am learning is how important it is for you to advocate for yourself. It look 9 months before anyone really took me seriously. I just had a baby and gained weight. It is important to listen to your body and advocate for what you need. You are worth it!! I know this is hard for me. I also don't want to live with the complications either. Trust your gut,head, and heart have all your questions answered even if you have to ask them again. In my orginal surgery my stomach was not transected. Maybe you will be feeling so much better. That is my hope. My thought are with you. Sherry
   — sherry K.