Question:
Open RNY stomach stapled not separated Lap RNY stomach stapled & separated?

I am wondering what is the difference between the stomach being separated and not separated in these two procedures. I know the difference in the procedure open vs. lap. Can someone please explain in simple plain language? I heard from the doctors. Any thoughts?    — Toby2 (posted on June 10, 2008)

June 10, 2008
I don't think many, if any, surgeons still perform a staple only procedure. There were too many problems with staple line disruption. In the RNY the stomach is transected (divided) into two completely separate parts, the new pouch and the closed off remainder of the stomach.
   — [Deactivated Member]

June 10, 2008
Whether u have Lap or Open doesnt make a difference if your surgeon opts to do a separation. It just means, in the separation, the end of the stomach to be formed into the pouch, is cut away from the existing stomach, and A staple line ( usually 4 rows of staggered staples) is applied to both the pouch and the stomach it was cut from. Some surgeons dont make the separation ( never could understand their reasoning) but i have watched over the years, and those that werent separated have more problems. Hope that answer helps you. Cindi -230#
   — DollyDoodles

June 10, 2008
The first poster was correct. There were too many problems with the staple only procedure. What would happen is that the staple line would separate and you would no longer have a separate pouch. The food would travel through the "hole" in the staple line instead of through the gastric tube that was created for it and you would have complete digestion in the stomach again. To solve the problem, the doctors began to SEPARATE the pouch from the bottom part of the stomach, and they also apply a SEALANT to the staple line that serves to KEEP the staples from separating. It acts like a GLUE and a sealant until the STOMACH can heal and seal itself so that there is NO CHANCE of a leak between the pouch and the lower section of the stomach. I hope that this answers your questions, Hugh
   — hubarlow

June 10, 2008
The issue with the staple without removal is it is all stomach material and you can strech the new small stomach and cause the staple to seperate and food go back into the old stomach. This is not done to often any longer because it can cause gainback and other problem. The best rout is to cut the stomach off and use some intestinal tissue to build the pouch about the size fo yor thumb. It will not strech. it is much harder to overeat, and you want the first third of the small intestine to go from the stomach with the stomach acid to the last third to aid in digestion. With out this, you would absorb sugar, and fat, and they would not make you ill. If you did that it would be like a diet, and you could binge eat. You want the stomach removed and set aside for the best success.
   — William (Bill) wmil

June 10, 2008
open or lap isn't the difference you are talking about. open just means they were unable to do it laproscopically. with lap they only make 5-6 small incisions and with open you have one long incision from your sternal area to the middle of your abdomen, but with RNY the same procedure is performed. i think you are asking the difference in the RNY vs. the old fashioned stomache stapling? with the RNY your stomache is stapled off and your intestines are actually resected and connected differently..... with the stomache stapling your stomache is just stapled to basically make it smaller for portion control and nothing is done with your intestines. none of your stomache is actually removed with either procedure, because it doesn't really need to be and if you develop some type of problems later the rest of your stomache is there and can possibly be reused,etc. it just kind of shrinks and sits there, but doesn't die or anything. it continues to make gastric secretions needed to digest and absorb your food. the stomache stapling is not used much anymore and from what i have researched there were alot of complications with that procedure later in life for most patients. it wasn't very successful in the long-term from what i understand. hope this helps and answers your question....Holly
   — RNlvnCARSON