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
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