Question:
Staple line disruption, What do I do NOW?

this was my second attempt for wls. The first time I tried I went into shock, so the surgeon didn't continue the surgery.Found out I was allergic to latex and pennicillin, It was a hard decision but I decided to have the surgery again. This time everything went well, I recovered fine, except for vomiting and heaving all the time. Ths is what caused the disruption. Now I'm stuck I don't know what to do. I thank God that I have lost over 80lbs and am greatful for that but I need to lose so much more, although I'm not gaining yet it's only a matter of time. I'm able to eat almost the way I did pre-op.I went from 346 to 262 losing the first 65lbs in 2 months, I'm 5 months post op. I also have a hernia that needs to be repaired. I guess my question is if you were in my shoes, would you attempt this surgery a third time? By the way, my doctor said the success rate is much lower because the first sugery falled. and he transect the stomach when he redo the surgery, I wish this was an option for me. I would have chosen transection. But he only does it if the first surgery fails, which doesn't make sense to me. If the success rate is lower and he transect the stomach, what if the staples disrupted again??This is scary,upseting and depressing I need help, PLEASE any info and suggestion are deeply appreciated.    — T E. (posted on April 3, 2001)

April 3, 2001
My gosh I really feel for you.. how terrible this must be. What a hard decision to come to. Fully reasearch the stomach transection and find out how it is closed.. stictching and staples etc? The transection is common and I don't know that breakdowns are as likely to occur if that makes sense. So did he tell you that the success rate w/ the stomach resected is less and why? is it because the pouch is bigger? Will you be going to the duoenal switch type procedure now? Either way this is totally up to you.. I know people who have had procedures with the stomach resected and they have lost weight and don't complain one bit... I think every little bit helps. I wish you the best and hope you can come to a decision. I think since you have to have the hernia repair.. if you do decide to opt for another weight loss surgey what time could be better?
   — Dawn R.

April 3, 2001
If It were me, I would do it but make sure this is a procedure that your surgeon is familiar with. You don't want to end up worse of because of a bad surgeon. Maybe you should bring these questions up with the surgeon? Whatever you decide, just remember you have friends here that can help you through it. Do they know what was causing you to be vomiting all of the time? Maybe that would be helpful infromation in deciding whether to go through with it or not. You will be in my prayers.
   — Emily P.

April 3, 2001
I just saw my surgeon and asked about the transection vs. just stapling. He said the transection usually works better because you must use a stronger closure than just stapling off a section of the stomach. I only know what he told me so that is not Gospel or anything. Have you considered spending some time on a second opinion to make sure you are doing the right thing? I will keep you in prayer that the right decision will be reached. Good luck.
   — Shannon S.

April 3, 2001
Do you have the option of another surgeon? A couple of things bother me. This WAS a 2nd procedure for you, whether the first one "took" or not. The risk was "spent". And since he knew that staple lines do disrupt and he chose to give you a disruptible staple line, rather than guaranteeing you a safer surgery, one wonders if he is to be trusted to give you the best the 3rd time through. I also had SLD, but my doc changed his procedure (1996) to transection after a number of SLD. My original surgery (1994) was during his learning curve however. There is more risk with revision, yes. But I returned to goal weight and my revision was totally uneventful. Perhaps you can find a surgeon who is more "up" on modern bariatric practice to do this revision and reduce your fears. Once the stomach is transected and has a chance to heal, it seals. Think of the paper cuts you've had on your finger. See any sign of it today? Once those raw edges knit together, they virtually seal shut. CAn't say that our stomachs are identical, but it is a much more permanent solution than the old staple lines + oversewing. For me, the choice was to risk the revision OR be assured of dying from my comorbs, after a few years of misery.
   — vitalady