[StacyC]

Originally Posted by DocSanae

Admittedly, there's a potential with this surgery that it's easier for the pouch to stretch. Also, the mesh that is used to prevent the pouch from stretching could move and get messed up. There was a newbie posting a few days back about having this problem and was scheduled for a revision, but the person's name slips my mind at the moment. I'll see if I can find the post later.

I would be interested in hearing about the newbie's issue :-)

I had the sleeve 12/20/07, and have lost about 50 pounds since surgery. As far as I know, no one uses "mesh" for the stomach, most surgeons just do the stomach transection. Aka, My surgeon stapled the stomach to separate them, then sewed over the staple line to prevent leaks. Im not sure where the "mesh" came from.

And, the stomach may stretch, but the RNY pouch is "stretchier," and there are very few studies that show enlarged stomachs. :-)

[DocSanae]

I attended a workshop about a year ago, where one of the leaders of the VSG study funded by NIH showed a slide with the mesh covering the sleeve. He explained that because of the stretching, the mesh was used by some surgeons, so whether it is used or not is up to the individual surgeon. It may have been experimantal, and could become one of these things that come and go.

He actually brought up the preliminary data from the study on the percentage of stretching with sleeve as compared to RNY, and I have to dig up my notes to get the actual number, but I think it was something like 10-15% with the sleeve, and under 5% with the pouch.

Because of which portion of the stomach is used, the RNY pouch is not any stretchier than the sleeve.
Anatomically speaking, the fundus is the portion that least stretches, and the larger curvature is where it stretches most.
For both sleeve and pouch, the larger curvature is what is removed from the the new route.
If you take a look at the respective diagrams of RNY and sleeve, you will be able to see that the same portion of the stomach is used for both the pouch in RNY and the sleeve. The cardia (the opening from the esophagus to the stomach) is intact in both methods, and while the pouch is stapled off from the rest of the stomach with only about a 15-25 ml volume, with the sleeve, the larger curvature is cut off at the top from about the same place where the pouch is made, parallel to the lesser curvature all the way down to the pylorus and leaving the pylorus intact.
The fundus where the tissue is the thickest, and least elastic is intact in both methods. The lesser curvature is softer and thinner than the fundus, the larger curvature is the most wrinkled, the tissue the thinnest, and easily stretched.

You may have the enlargement of the stoma confused with the stretching of the actual pouch. Enlargement of the stoma does happen, but the rate is not high enough that it comes up as an independent issue in the long term follow up studies that have been published in the last year or two. As a matter of fact, the most recent papers are all very favorable to RNY. With VSG, it is going to take 5-10 years before similar data can be accumilated, as these studies have followed patients having surgery from as far back as 1984. I also believe there is an ongoing study on correcting enlarged stomas, though from what I've read, it's only just started.

[Cockney]

Hi Guys. Today is my one year anniversary of my sleeve gastrectomy. I have lost 140 pounds and about another 38 to go.

I don't post here very much, but since I found you, I have always turned to the site for both information and the desire to "be" with others that really understand what I have been going through.

Thanks for your support over the last year, thanks to Doc for so much insight, and especially thanks to Micheal for making it possible.

Cheers

Tim

[TamTamW]

Congrats on your one year surgiversary, you have done very well. And only 38 more to your goal way to go.