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When does the stitch line completely Heal?



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My doctor said it takes more than seven months for the staple line to heal? That's a long time. Is it true? What have you heard?

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6 weeks for healing time on the sleeve per my surgeon, but no soda until after goal, it hurts if you drink it too early because there is residual swelling and the bubbles make it uncomfortable. As for steak, my post-op guidelines don't recommend eating solid meat for 6-8 weeks post-op. Steak is pretty difficult to digest early out, and I couldn't eat but a couple of bites when I first tried to eat steak. It took me a good solid 3 months to be able to eat just a couple of steaks, and it was fajita meat(skirt steak).

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My doctor and dietician said that the carbonation in soda can stretch your sleeve so i wouldn't recommend ever returning to soda.

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It was recommended by the NUt to not ever drink soda again.

As for steak I am 7 weeks out and it is one of the easiest things for me to eat. Started on food at 4 weeks. After 1 week of purees and 2 weeks soft foods. chicken gets stuck, fish gets stuck. So red meat has been my lifeline to Protein goals. I can even eat beef jerkey with no issues. I just make sure I chew, chew, chew. I can only eat about 1.5 - 2 ounces of steak but at least it stays down.

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My doctor and dietician said that the carbonation in soda can stretch your sleeve so i wouldn't recommend ever returning to soda.

There is absolutely zero scientific evidence to prove that carbonation can stretch the sleeve. There's not even scientific evidence that it can stretch RNY or Band pouches. Yes, sodas are empty calories, leech the Calcium out of bones, and will make you burp or fart, but the tissue that remains after a sleeve is not extremely stretchy tissue, and, once liquids hit the pyloric valve they dump into the intestines just like Water, tea, coffee. It isn't like soda is sitting in there hanging out all day in our stomachs.

I will say that early out when there is residual swelling, the carbonation can be too much for the sleeve and it might be uncomfortable, but it's nearly impossible to stretch the remaining stomach tissue out to any major degree especially with soda. There isn't enough left to stretch unless the fundus isn't fully dissected and removed from the body.

I know a lot of surgeons and nutritionists recommend laying off soda, and I'm not advocating it to anyone, but I've been drinking soda for nearly 10 months with zero change in my sleeve capacity.

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I know all docs are different however, My paperwork from the very beginning says we can drink flat soda. Even in my nutrition class she said to let it sit out a while and then drink it. I have weaned myself and have not even craved soda but, if you are maybe this would help. I already burp with just about everything I drink so, I don't dare go there yet. But, I'm only a week and a half post op.

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I have been reading lately about soda, even diet soda will cause a stall in weight loss. Must be something to do with the chemical components. At any rate, I stopped soda 12 weeks prior to surgery and I lost 40 pounds in that short amount of time. Granted the last week was high protien and then shakes 2 days prior. I really think cutting the soda out has helped.

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I was told sodas never, steak at 1 month out and your line heals after 3 months!

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.... There isn't enough left to stretch unless the fundus isn't fully dissected and removed from the body.

Tiff, I hear a lot about the "stretchy tissue" being removed during VSG, and not during RNY, but is there medical studies out there that reinforce this idea that there is stretchy tissue and not so stretchy tissue? Thanks for anything you might have in your bag of tricks/links that discuss this...

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Like Tiff, I've been drinking diet soda also. I started at 3 months out - it did feel a bit uncomfortable at first, but now it's no problem at all. I definitely drink less because it "fills me up", but I enjoy some almost every day.

That being said, if YOUR doctor says no, then YOU should follow their advice.

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Tiff, I hear a lot about the "stretchy tissue" being removed during VSG, and not during RNY, but is there medical studies out there that reinforce this idea that there is stretchy tissue and not so stretchy tissue? Thanks for anything you might have in your bag of tricks/links that discuss this...

The fundus is the stretchy part of the stomach that is removed during VSG, and that tissue remains with RNY and the Band.

I think this might help illustrate the differences.

vsgpiclap.jpg

Anatomy

This procedure generates weight loss solely through gastric restriction (reduced stomach volume). The stomach is restricted by stapling and dividing it vertically and removing more than 85% of it. This part of the procedure is not reversible. The stomach that remains is shaped like a very slim banana and measures from 1-5 ounces (30-150cc), depending on the surgeon performing the procedure. The nerves to the stomach and the outlet valve (pylorus) remain intact with the idea of preserving the functions of the stomach while drastically reducing the volume. By comparison, in a Roux-en-Y gastric bypass, the stomach is divided, not removed, and the pylorus is excluded. The Roux-en-Y gastric bypass stomach can be reconnected (reversed) if necessary. Note that there is no intestinal bypass with this procedure, only stomach reduction. The lack of an intestinal bypass avoids potentially costly, long term complications such as marginal ulcers, Vitamin deficiencies and intestinal obstructions.

Gastric Bypass - The Digestive Process

To better understand how the gastric bypass weight-loss surgery works, it is helpful to know how the normal digestive process works. As food moves along the digestive tract, special digestive juices and enzymes arrive at the right place at the right time to digest food and absorb calories and nutrients. After we chew and swallow our food, it moves down the esophagus to the stomach, where a strong acid and powerful enzymes continue the digestive process. The stomach can hold about three pints of food at one time. Food is slowly released into the small intestine where absorption of the nutrients, Vitamins and minerals takes place. The rate at which foods and fluids are released into the small intestines is controlled by a sphincter on the outlet of the stomach. Empty time can be over several hours.

schauer_digestive_process.jpg

Procedures

Procedures

Bariatric operations currently performed include gastric restriction (vertical banded gastroplasty; laparoscopic adjustable gastric banding), malabsorption (biliopancreatic diversion; biliopancreatic diversion with duodenal switch), or both (Roux-en-Y gastric bypass). Two of the most commonly performed bariatric surgeries are the laparoscopic adjustable gastric banding procedure and the Roux-en-Y gastric bypass. Roux-en-Y Gastric Bypass Surgerybagzumzz12682.jpg

The most common bariatric surgery procedure performed in the United States, Roux-en-Y gastric bypass (RYGB) combines a restrictive and malabsorptive procedures. A small (15-30 cc) gastric pouch is created to restrict food intake and a Roux-en-Y gastrojejunostomy provides the mild malabsorptive component. Bariatric surgeons can perform the Roux-en-Y gastric bypass procedure using minimally invasive surgical techniques.

The advantages of Roux-en-Y gastric bypass include superior weight loss when compared to vertical banded gastroplasty, with excellent long-term weight reduction and resolution or elimination of co-morbidities (80 percent resolution of Type II diabetes after surgery). Early and late complication rates are reasonably low, and operative mortality ranges from 0.2 percent to 1 percent.

Disadvantages of Roux-en-Y gastric bypass include the potential for anastomotic leaks and strictures, severe dumping syndrome symptoms and procedure-specific complications, including distension of the excluded stomach and internal hernias. Roux-en-Y gastric bypass is technically more challenging to perform than the restrictive procedures, particularly when using the laparoscopic approach. In experienced hands, the conversion rate of laparoscopic Roux-en-Y gastric bypass to open is 5 percent.

Laparoscopic Adjustable Gastric Banding

ddnlxtvp12683.jpgA restrictive procedure, laparoscopic adjustable gastric banding (LAGB) involves placing a silicone band with an inflatable inner collar around the upper stomach. The band is connected to a port that is placed in the subcutaneous tissue of the abdominal wall. The inner diameter of the band can be adjusted according to weight loss by injecting saline through the port.

Laparoscopic adjustable gastric banding surgery is performed laparoscopically, offering less surgical trauma in the wound and to the viscera, improved postoperative pulmonary function and decreased incidence of wound-related complications such as hematomas, seromas, infections, hernias and dehiscence. LAGB is technically the simplest bariatric surgery to perform and requires less operating time than other procedures. No anastomoses are created, and the morbidity and mortality are low. The procedure is reversible and, if patients fail to lose adequate weight after laparoscopic adjustable gastric banding, it can be converted to a Roux-en-Y gastric bypass.

The disadvantages of laparoscopic adjustable gastric banding include the need for frequent postoperative visits for band adjustments and band slippage or gastric prolapse through the band (5 percent to 10 percent), which requires re-operation. Band erosion into the stomach, gastroesophageal reflux, esophageal dilation and dysmotility also can occur.

With these illustrations, you can see that the fundus is intact, and the pouches are both involving some fundus tissue. Stoma(opening from pouch to intestine) stretching is pretty common among RNY which allows food to dump into the intestines faster, and allows patients to eat more.

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I drink diet coke once in a while, when I go out with a bit of vodka or Malibu, or sometimeson it;s own when i just feel like it, especially now that I'm nearly 4 and a half months out. I do let it go quite flat though, just in case.

I love those illustations Tiff, especially the 1st one, wher we can see perfectly well how reducing the size of the liver can make surgery a little bit easier by making the stomach more accesible, thanks for sharing!

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I had the sleeve on Nov.19th. I will be 4 weeks post op on Dec.17th. I have been dying for a steak. I am an emotional wreck! My family and friends don't understand what I am going through. I need to find some "sleeve" friends that understand what's happening to me.

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I had the sleeve on Nov.19th. I will be 4 weeks post op on Dec.17th. I have been dying for a steak. I am an emotional wreck! My family and friends don't understand what I am going through. I need to find some "sleeve" friends that understand what's happening to me.

At 4 weeks, how are you feeling? Are you losing weight? I'm 3 days post op.

Misty

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