mikef

Leaks - Why?

8 posts in this topic

I have read about leaks and long hospital stays. That scares me. What do you guys think causes some people to have leaks and others not.....  do you think it is the surgeon not doing a good job?  Some surgeons better then others?  Curious as to some sort of reason. Thank you. 

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Given the risk of leaks is multiple times higher in revisional surgery I suspect it has to do with the health of the stomach wall. Previous scarring or stretching may impede the ability of the wall to adhere to itself and heal properly. Logic says it shouldn't be the staple line at fault as the staplers put three lines of staples in simultaneously. I guess though that particularly where a smaller staple gun is used in a laproscopic surgery there would be room for surgeon error, but that shouldn't happen with an experienced surgeon who does a blue saline leak test before closing you up. It is definitely a question worth asking your surgeon though.

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I asked my surgeon and he said they were so rare that it's still unclear what causes them.  I've been super paranoid about it.

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2 hours ago, TentativeMe said:

I asked my surgeon and he said they were so rare that it's still unclear what causes them.  I've been super paranoid about it.

My surgeon says they are one of the most likely complications to occur in revisional surgery. It's certainly the one he's said he's most concerned about. I'm pretty sure I've read something similar here in one of the Ask Dr Callery threads as well.

I actually have to spend extra time in hospital after my surgery because of the risk of leaks. My surgeon says he won't discharge me until he's confident I don't have any leaks. It's scary stuff to be told that at every appointment.

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1 hour ago, Aussie H said:

My surgeon says they are one of the most likely complications to occur in revisional surgery. It's certainly the one he's said he's most concerned about. I'm pretty sure I've read something similar here in one of the Ask Dr Callery threads as well.

I actually have to spend extra time in hospital after my surgery because of the risk of leaks. My surgeon says he won't discharge me until he's confident I don't have any leaks. It's scary stuff to be told that at every appointment.

I don't know if there is any reliable way to predict who will get a leak.

what criteria is he using to determine if you are developing a leak?

your length of stay is way longer than the majority of people.

my surgeon doesn't even do the after surgery swallow test any more. He has done close to 4000 sleeves and  has had 1 leak. He wants patients home and learning how to manage  their new post  weight loss life in your real life.

best wishes....

 

 

 

 

 

 

 

 

 

 

 

 

i certainly would

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Leaks happen. IIRC one of the main reasons is insufficient vascularization in the region of surgery (but my surgical training was long ago :lol:). It can happen after every surgery and is not specific to WLS.

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7 hours ago, Spunkycat said:

I don't know if there is any reliable way to predict who will get a leak.

what criteria is he using to determine if you are developing a leak?

your length of stay is way longer than the majority of people.

my surgeon doesn't even do the after surgery swallow test any more. He has done close to 4000 sleeves and  has had 1 leak. He wants patients home and learning how to manage  their new post  weight loss life in your real life.

 

 

Simply because it is revisional surgery and therefore multiple times (from memory he said 20x) higher risk of leaks which according to him are what surgeon's worry about most complication wise. In Australia a gastric bypass hospital stay is normally about 4 days, mine will only be one or two days longer. I will be subjected to the swallow test but he only does them with revisional surgeries. Unlike other gastric bypass patients who only have the one multiple staple line placement, I'll be having two that I know of because along with the bypass I'll also be needing a gastrectomy otherwise the tissue between the old dehiscence and the new stapleline will become necrotic due to having no blood flow.

There are probably multiple thoughts contributing to his concerns. During my pre-surgery endoscopy there were lots of internal measurements taken to map out the damaged stomach tissue so the regional bariatric surgeons meeting could discuss if and how to tackle scar removal and whether the surgery should even be done at all. I have complete faith in my surgeon, he has taken a very considered approach to my upcoming surgery. Everything seems to have been planned down to the last detail, including him being rostered at my local regional hospital when I'm allowed to return home. Can't ask for better service than that!!!!

 

 

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This is one of Dr Callery 's posts regarding leaks

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