Question:
9- months post op from open gastric by pass. Upper G.I. show no pouch or staple line

Surgeon said this a SLD, but there is nothing left indicating there was a pouch. Any One please shed sonme light. Help    — Gloria D. (posted on May 21, 2003)

May 21, 2003
I don't quite understand this question...can anyone explain? What is a SLD? And why would the Upper GI not show a pouch or staple line?
   — Tarah S.

May 21, 2003
My interpretation of your results is that you were not transected during your original surgery. You had a row (or several rows) of staples inserted to partition off your stomach. One side is made extremely small and would be considered a "pouch". However, since your surgery, those staples have loosened/pulled out and your stomach is no longer divided, but fully intact. This is an SLD or staple line disruption. There is nothing that you have done to cause this. It is simply a malfunction of the mechanics of surgery. There is no way for the two sections of your stomach to grow together since they are made of mucous membranes. They can not form a scar and seal off. Over time, this leaves the strong possibility that those staples will work themselves out and you will develop an SLD. Remember, it is nothing you did that caused this. Now, fortunately for you there is a remedy. Many people will have a revision and fix this situation. For some reason, many surgeons will simply go back in and restaple!! Does that make any sense? I would definitely INSIST on being transected. Then your stomach will be surgically divided into two separated sections, preventing the chance for an SLD. The edges will be stapled and often oversewn and will form scar tissue and heal over. Again, insist on being transected next time. Many people on this site have had the same problem. I would recommend talking to Marilyn Childers. She had the same problem at about the same time post op. Shelley
   — Shelley.

May 21, 2003
As far as I know there would be nothing indicating there was a pouch, it would just look like a normal stomach since the staples are gone.
   — Saxbyd

May 21, 2003
Shelly is 100% correct. This happened to me and when the surgeon went back to redo and transect, he saw no sign of the original 8 rows of staples. Now that I am transected, all is well. I just had an upper GI and now at 18 mos post op from the revision, my pouch is still little and no problems. I, along with others on this site, have strongly encouraged others to make sure they are transected when the rny is done so that you won't have SLD. This mechanical failure happens a lot more than the 2% statistic quoted by surgeons. The only way to fix it is to have the surgey all over again or you will probably regain all your weight that you lost. I went back and had the revision asap when I found out I had SLD....within a month. Luckily, Dr. Bergstein was willing to do it as quickly as possible. He is a caring man. Does your surgeon recommend a second surgery? Please let me know if I can help you in any way with questions, etc. Most of all, don't feel like you have failed. I know that I felt so guilty and very depressed when I quit losing at 68 lbs lost. Thanks to Michelle Curran, the vitalady, I was able to understand what had happened and deal with it. Good luck to you, Gloria.
   — Mylou52

May 21, 2003
Shelly is 100% correct. This happened to me and when the surgeon went back to redo and transect, he saw no sign of the original 8 rows of staples. Now that I am transected, all is well. I just had an upper GI and now at 18 mos post op from the revision, my pouch is still little and no problems. I, along with others on this site, have strongly encouraged others to make sure they are transected when the rny is done so that you won't have SLD. This mechanical failure happens a lot more than the 2% statistic quoted by surgeons. The only way to fix it is to have the surgey all over again or you will probably regain all your weight that you lost. I went back and had the revision asap when I found out I had SLD....within a month. Luckily, Dr. Bergstein was willing to do it as quickly as possible. He is a caring man. Does your surgeon recommend a second surgery? Please let me know if I can help you in any way with questions, etc. Most of all, don't feel like you have failed. I know that I felt so guilty and very depressed when I quit losing at 68 lbs lost. Thanks to Michelle Curran, the vitalady, I was able to understand what had happened and deal with it. Good luck to you, Gloria. The second surgery is a lot easier than the first one as the intestinal bypass is still intact and all the surgeon has to do is "redo" the staples and transect the stomach into two separate parts. Of course, with open surgery it is still not easy but putting the original rny at a 10 in difficulty, the revision was in my case about a 7.
   — Mylou52