The stomach left behind...

[njlimmer 344]

I had my RNY on 3/3, and there's a bizarre question that has been taking up way too much of my brain. Unlike the sleeve, the rest of our stomach is still in there. How does it stay in place? Like... is it just floating? Can it shift? Could it migrate somewhere else and end up all twisted? Sorry... it's just been in the back of my mind!

[toodlerue 463]

Thanks a lot! Now I can't stop thinking about it 😹

IDK, but I sure hope someone can answer this for us!

[njlimmer 344]

8 minutes ago, toodlerue said:

Thanks a lot! Now I can't stop thinking about it 😹

IDK, but I sure hope someone can answer this for us!

RIGHT?!!! I'm going to ask my NP if no one else has an answer, but they always give me the oddest looks when I ask my curiosity questions. I'm a librarian so weird, obscure questions are a job hazard.

[The Greater Fool 2,075]

I know things DO move around. My heart used to be in my stomach.

[GreenTealael 25,631]

Don’t fret!

After RNY, the remnant stomach is usually left in its original place. The abdominal cavity is packed pretty tightly so nothing is just floating - unlike VSG where a some space is made by removal of part of the stomach. (Reenactment of my original VSG below )

[dms75 161]

From here:

https://www.ecommunity.com/services/community-bariatric-and-medical-weight-loss-services/faq/after-surgery

" What happens to the lower part of the stomach that is bypassed?
The stomach is left in place with intact blood supply. In some cases it may shrink a bit and its lining (the mucosa) may atrophy, but for the most part it remains unchanged. The lower stomach still contributes to the function of the intestines even though it does not receive or process food—it makes intrinsic factor, which is necessary to absorb Vitamin B12, and contributes to hormone balance and motility of the intestines in ways that are not entirely known. "

[Elidh 241]

before and after. The stomach is not left free-floating afterwards.

[The Greater Fool 2,075]

Actually, I think it is this sort of simplified picture that spawns the question. A lot of detail is left out that leaves things "hanging in mid abdomen" as it were. To understand the concept of surgery, we don't really need all the complicated detail.

However, the more complete and scaled 'before' picture shows how there is a lot more going on around the stomach, so not much room or direction for things to move about willy-nilly.

[It's time. 145]

Scar tissue forms to hold it in place.

[The Greater Fool 2,075]

13 minutes ago, It's time. said:

Scar tissue forms to hold it in place.

Optimally, no.

At least according to my surgeon. Such scar tissue attaching would have been an adhesion and undesirable.

Nothing is required to hold the stomach in place before surgery or after.

[catwoman7 11,285]

it's still in place. They just separate the two parts with surgical staples. As far as I know, the two parts are not physically cut apart or anything. In fact, the RNY is technically reversible (although they don't do it unless the patient has some severe issue that can't be resolved any other way - or if they're going to revise it to a duodenal switch - in which case they reverse the RNY and then sleeve your stomach)

Edited April 7, 2021 by catwoman7

[The Greater Fool 2,075]

4 hours ago, catwoman7 said:

it's still in place. They just separate the two parts with surgical staples. As far as I know, the two parts are not physically cut apart or anything. In fact, the RNY is technically reversible (although they don't do it unless the patient has some severe issue that can't be resolved any other way - or if they're going to revise it to a duodenal switch - in which case they reverse the RNY and then sleeve your stomach)

Caveat: Surgeons have their own ways of doing things so I only am positive about what my Doc did.

My Doc used a special tool that created the staple lines and bisected the stomach in one process. Doc said that if the stomach wasn't bisected that staple line failure over time was more common.

I asked about reversing RNY and he said that yes, it could be reversed, but it was akin to knocking down a house then rebuilding it again from the rubble. It will work but it won't be pretty and it won't work the same.

[ms.sss 15,861]

14 hours ago, GreenTealael said:

Don’t fret!

After RNY, the remnant stomach is usually left in its original place. The abdominal cavity is packed pretty tightly so nothing is just floating - unlike VSG where a some space is made by removal of part of the stomach. (Reenactment of my original VSG below )

This is funny and gross at the same time.

hahahhaha.....eeeewwwwww....

[njlimmer 344]

Those are some great answers! I actually do feel better! I was thinking it was just like jellyfish-y floating around in there, but that makes SO much more sense!!

[Darktowerdream 421]

I have not been around much and I have thought about this question also. I know the stomach is only separated by a staple line. But do wonder if the fact that it is only separated by a staple line can cause ulcers at the junction point between pouch and intestine (in some people that were previously prone to them) I sometimes question if my body is adverse to the staple line. I am nearing my two year anniversary it is so hard to believe that. But am struggling with some problems eating. and an ulcer. I did see my surgeon a few months ago, but besides medication even my gastroenterologist had no answer and the meds are not working they just dont work for me. This question made me think how I question what role the remnant stomach has in this.