Question:
What is the diff? Transection vs, Stapling

what is the difference between being transected vs.stapled-and is your stomach still stapled if you have a transection. I am confused-I am open RNY, but really don;t know much more than that-what questions should I ask my surgeon to find out more info on what was done to me? And if I was stapled -can I still be transected now or only if a problem occurs?I am now worried about SLD later on post-op    — TotallyTori (posted on April 30, 2003)

April 30, 2003
transected means cut off, cut away removed. they staple or sew ( depeneds on the dr) the new pouch then cut away the old stomach, so it is no longer attached. staped inplies it is only staped apart, which the staples can come off or slip and the old large stomach began to be used defeating the purpose.
   — janetc00

April 30, 2003
Yes, transected means to cut away not just staple. And yes, it has a very slight possibility of coming unstapled. However. Being transected has the possibility of coming undone too. The only difference is .. Where is it going to leak to? There is no additional(stapled)stomach remaining .. it was cut away. Just another thing Dr and patients disagree on. You just have to research and do what you think is best for you. Good luck.
   — Sarah H.

April 30, 2003
Most surgeons today transect because our bodies work to fix themselves this statement from my surgeon. This fixing causes staple line disruptions. Ask anyone who has lived with a SLD, weight regain, sick, having to go thru another surgery. On anti acids. All not fun. Check outr Michelle Currans profile.
   — bob-haller

May 1, 2003
When you are transected, the stapler "fires" staples and cuts the stomach along the lesser curvature of the stomach, i.e., a vertical cut. So therefore, you are cut and stapled. Transected means cut away physically from the old stomach. When I had SLD and had an upper GI, you could see the barium (white in the picture) flowing over the top of the pouch and into the old stomach which was laying right next to the pouch. Now, that I am transected and there is no leak, in my last upper GI all we could see was a little finger shaped pouch. It was about the size of the distance between two vertebrae which was also visible in the picture. If you are stapled without transection, the stapler fires rows of staples but does not cut the two (the pouch and the old stomach) apart. I had eight rows of staples without transection in my first surgery and you would think that would hold forever, but when the surgeon redid my staple line with transection, he could not find any of the staples! They are really small. With transection, the edge of the pouch and the old stomach form scar tissue which makes a permanent seal. It usually forms in a few days and the chances of a disruption are almost nil. There is always a chance of disruption without transection. Lately, I have heard of a few people forming fistulas from the pouch to the old stomach. This is a connective tissue bond but according to my doctor, hardly any food can flow through this connective tissue. The body is always trying to "heal" itself though when it senses something is not right. Michelle Curran says that is why it is so important to continue to "fool" your body into believing all is ok and normal by taking your supplements and vitamins. Then the body will ignore the "foreign environment" and maybe we won't form more villi in the intestines to increase absorbtion and/or fistulas. Makes sense to me! If I can help in any way, just e mail me or read my profile #2 and #1 on my SLD and revision.
   — Mylou52

May 1, 2003
At least that is my personal theory on hypertrophy. Look at it this way, stapling (alone) is probably temporary. Transection is probably permanent. There are always going to be exceptsions to either rule. My husband is stapled RNY (7.5 yrs) and still intact. Don't know why--he was never careful about portions. Some who have been transected grow a fistula (little bridge between pouch & old stomach). Figuring that if my body spit out the staples once, the pouch would probably go looking for its buddy, I preferred to have the old stomach completely removed. NOw, before you freak out, realize thatI had 30 yrs of ulcers and that bag was full of pits & scars, just dying to make more ulcers for me. And no, I'm not sorry I did it. But better yet would've been to be transected in the first place & skip the revision surgery. Who knows, maybe having to do it twice made me more appreciative?
   — vitalady