Question:
What causes a Leak?

I was wondering what causes leaks? Not chewing well? What exactly are they?    — Renee B. (posted on February 11, 2003)

February 11, 2003
Are you talking about the RNY? If you're talking about a leak immediately post-op, where the pouch or stomach are not entirely closed so that one is leaking into someplace it isn't supposed to, sometimes such a leak is a surgical failure -- not necessarily negligence, btw, just that something didn't take. It can be life-threatening if substances leak from the stomach or the pouch into the abdomen, which is why watching out for leaks in a fresh post-op is such a big deal. <P>If you're talking about staple line disruption type of leak, where the leak allows substances to go from the pouch into the stomach, my understanding is that some people can overstuff the pouch such that it pulls the staples out, or in some cases, the body just rejects the staples as foreign objects, over time, regardless of patient compliance. Bad thing all around. Many folks get a revision surgery if they suffer a staple line disruption, because of course they find they can eat more if the pouch and stomach get reconnected. The best thing to do is transsect the stomach and pouch (that is, cut them apart and sew them up separately, instead of putting lines of staples between them). I don't know why transsection isn't standard procedure -- my guess is, it takes longer in surgery, and docs are playing the odds. Staple line disruptions are relatively uncommon. I've seen people say they happen anywhere from 3-5 percent of the time to 10 percent of the time. No idea of the basis for those stats, though. And even more confusing to me, some people say they're transsected -- by staples only. I don't understand that one.
   — Suzy C.