Theory about leaks at 2 weeks

[cajun 46]

Hi Friends,

Leaks seem to be very rare but do you agree that it sounds like 2 weeks post-op is when they are most likely? From what I read, I think that may be the case. I have a theory about what might cause them.

Those of you who are nurses like me know that about 2 weeks post tonsillectomy, when the "scabs" fall off the wounds in the throat, there is an increased incidence of hemorrhage. Well, I wonder if two weeks post VSG when the stomach incision "loses it's scab", there might be a greater chance of a tiny opening showing up where it falls off. That is also a time when many people start to advance their diet, and maybe put a bit more into the sleeve, which could make the opening a little bigger still.

Voila. A leak!

Sound plausible?

[Ruthi 60]

yes, considering that not all will follow their post op diet and advance to a more solid food before they should and that is what would cause a leak at 2 weeks. Probably why Dr Aceves put pts on liquids for 3 wks

[DownInSocal 12]

Interesting!

[MacMadame 81]

Actually, I haven't seen that 2 weeks is a common time for leaks. I see a mixture of times when people have them. A lot get them right away and some have them right away but it takes a while for them to be diagnosed. Once they are diagnosed, it becomes clear they had it from day one.

[cajun 46]

I have a couple of questions:

"Once they are diagnosed, it becomes clear they had it from day one."

If a leak is found at two or three weeks, how is it determined to have been there from" day one"?

I would guess that some sleevers do everything right but still get a leak...what causes that, does anyone know?

Thanks for info.

[MacMadame 81]

Leaks are more likely to occur if:

You are SMO

You are diabetic

You smoke

That's about how you heal.... those things interfere with your body's ability to heal.

Some surgeons are less skilled than others and have a higher leak percentage... that's surgeon skill

But anyone can heal poorly that one time... that's just random chance.

As for it being there all along, some people have symptoms from day one... extreme pain, nausea/pain after eating. But it gets misdiagnosed. So they are told "it's just gas" or "it's nausea from the anesthesia". But the symptoms don't go away and, eventually, it's very clear that it's not "just gas" or it's not "from the anesthesia".

So then the medical staff looks harder and finds a leak. At that point, you realize, you had that leak from very early out.

[attitudefree 2]

What does "SMO" stand for?

[MacMadame 81]

Super Morbidly Obese. It's a BMI over 55. (Or some say 60.)

[WhiteRice 0]

So then the medical staff looks harder and finds a leak. At that point, you realize, you had that leak from very early out.

I'm curious... Don't all docs do a post-op leak test? I had a contrast radiograph on day 2. I thought that was standard.

[cajun 46]

That is my understanding also.

[TennJenn 9]

I'm curious... Don't all docs do a post-op leak test? I had a contrast radiograph on day 2. I thought that was standard.

I'm pretty sure I've seen surgeons who only do the one leak test while in the OR.

[cajun 46]

Hi Jenn,

I love your pen signing your name. Where did you find that? So cool!!!

Cajun

[WhiteRice 0]

Can you all see my ticker in my sig up there ^?

[cajun 46]

Nope, no ticker. Sorry.

When you figure it out let me know. I want to add one too.

Cajun

[MacMadame 81]

Some do leak tests and some don't. LapSF used to do leak tests in the OR and after. But they never found a leak that way. Then, people would leave the hospital and a few days later, they'd have a leak! So they speculated that something about the leak test in the OR was stressing the staple line and they stop doing them. They'll do them after, if you request it or you have certain symptoms. But they don't do them regularly. And, since they made that change, they haven't had a single leak! It's been almost 2 years too.

They still do leak test in the OR and hospital for DS and RnY but those guys have a different kind of staple line. (Plus, Dr. C hand-sews some of the trickier connections.) So the leak tests don't seem to stress the staple line in the same way. He's never had a RnY leak, last time the subject came up.