Question:
RNY or Lap Band

When I initially met with my surgeon, I had my mind set on the Lap RNY. He advised that since my belly is smaller, he would try to do the surgery lap but chances are that he would have to convert to open. The cosmetic thoughts about the large scar have me leaning towards the lap band. Can anyone provide any guidance?    — kc1978 (posted on December 27, 2005)


December 27, 2005
I personally had RNY but if I was in your situation I would go with the band.
   — jengriggs01

December 27, 2005
Can you get a second opinion? Lap is the way to go. I was only 100 lbs overweigh and the lap went well.
   — shoutjoy

December 27, 2005
Its a trade-off. I requested open when I could have had Lap- simply because as a surgeon myself, I wanted the best navigational area for my surgeon to use- and the scar, heck it is almost non existant. It all depends on what outcome you are looking for. Take the tiime to weigh the pros and cons of the types of surgeries, and how it will fit into your life- your age, whether you are going to be a bikini person post op, there are many things to think about, Doing it again, I would still go open, because I hate gas pains, and knew I would have the severe post op gas with the lap procedure, but thats just me. Good luck on your choice
   — DollyDoodles

December 27, 2005
The lap band is a wise choice - IMHO, the wisest. You will never see a bandster 3 years old asking about getting a revision --- all it takes is having your saline "fill" being fine-tuned, and commitment to not cheating your band. I started at a BMI of 47 and I'm already down, after 8 weeks, to 45. I take a daily Centrum, but otherwise, my life is normal --- except for the fact that my appetite is a fraction of what it used to be. Theresa
   — SouthTX LapBand

December 27, 2005
I too was only 100 lbs overweight and had a Lap RNY and it went fine...I never heard of a surgeon not wanting to perform one because of a small stomach. I'd get another opinion.
   — monkey-dee

December 27, 2005
Honestly - I'd look for a more experienced surgeon! You want to find one who has only RARE instances of Lap procedure being converted to an Open procedure. My surgeon does Lap DS and Lap Sleeve gastrectomy - he hasn't had to convert to an open procedure in over a year and a half - he's doing lap on people with a BMI as high as 70. They recover swiftly, lose their weight incredibly well, and then when it's time for PS - there are virtually NO scars to show for it! It's amazing! I went through pre-ops with a bunch of folks - choosing between Lap Band, RNY, and DS. That particular surgeon was very strongly pushing Lap Band. I'm now 3.5 years post-op DS (I went through pre-ops for Lap Band, but ended up being self-pay for DS) and those folks that I went through pre-ops with are now by and large seeking conversion to another surgery due to failure to lose weight, miserable quality of life, and mechanical failure issues. If you have a lesser amount of weight to lose - why not choose a surgery that is less invasive? Lap Sleeve Gastrectomy seems to be the wave of the future. There's no foreign body to worry about - no worries about the port rubbing against internal organs and causing scar tissue problems, no worries about band slippage or erosion into the stomach wall, infections at port sites, etc. If I had to choose between Lap Band and Sleeve Gastrectomy - the Sleeve Gastrectomy would win hands down! Retaining pyloric function is nothing to be sneezed at! Whatever you choose - be proactive for yourself! This decision is for the rest of your life! Make sure you get to know folks in real life (local support groups, etc) who are 1, 2, 3, 4, and even 5 years post-op - find out what their quality of life is like. Find out what it's like eating out with them. Ask them if they'd do it again. Ask them if they'd want their dearest loved one to take the same path they have. Answers to those kinds of questions had a huge impact on me as a researching pre-op - and I'm eternally grateful for the candid input that so many people gave me. Best of luck to you! Blessings, dina
   — Dina McBride

December 27, 2005
There is a lot to consider, but when all is said and done,, it is not the scar or the procedure (horses for courses, go to a support group and meet others with different procedures, and make some imformed decisions that way) but the almost inevitable tummy tucks and other types of plastic surgery that come along the way after being a successfull patient. These also produce some scars, but without them you might look like a Sharpei puppy. As a recipient of Tummy Tuck, leg Lift, breast reduction and lift, the scars that result from these surgeries do not compare with the joy of looking damn good in your new clothes and amazing your friends and relatives with your total remake and new found brilliance. (That is if you are up to following the surgeon's nutritional and exercise protocol, because then and only then will you get the full package, weight loss, health, and good looks again.) The scars from these types of surgeries do not last forever and generally devascularize and diminish in a couple of years to a white line that no one sees. Good luck and get into a support group soon. Glad you can ask for help here, but find a coffee buddy to talk to and set your mind at ease. Good luck
   — Lise K.

December 27, 2005
You received some great advice about seeking a second opinion from a more experienced surgeon. If you are not a good candidate to have laparoscopic RNY, then wouldn't the same limitations prevent you from being a candidate for laparoscopic Lap Banding? Whether you choose the RNY or the Lap Band should be your own personal decision made after consultation with experienced surgeons. Just remember that the field of view is actually better with the laparoscopic procedure than the open one (because there is less blood and because the image is magnified) and the operating room time is shorter (assuming surgeons of equal skill) because there is less time required to prep the area and to then close it up. Review the many times this same question has been posted in this forum and you will see the widely divergent opinons about the procedures. Also, be prepared for lots of misconceptions-- the Lap Band, although successful for some groups of people, is simply not the risk-free, one-size fits all method that its staunchest proponests would suggest. But, the decision you make must be the one that fits you the best.
   — SteveColarossi

December 27, 2005
I dont believe the issue is not band or rny but open or lap, I would find a different surgeon, state of the art is laparoscopic, be it gall blader, nissan wrap, kidney, apendexdimey, lap band, rny, knee surgery, DS, need i go on? The band AND the rny are a world apart, success rate, life after surgery, between the two. Have you considered the third choice, the DS,I cannot have either the band or the rny, incompatible with my comorbids, gerd,and insipudus,and Nissan wrap, (which was done lap 10 years ago) before i was obese, and open is out of the question. i am only 65lbs over goal at present, want to CURE my diabetes II. visit the ds forum.
   — walter A.

December 27, 2005
Boy, I couldn't agree more with Cindi about open vs. lap for pain. I had a lap for my gallbladder and that gas pain was incredible. The open rny for me was a piece of cake. LOL. But like the last person who posted said, it's not a matter of RNY vs. band as much as lap vs. open. Decide what procedure you want the most and look for someone who can provide a better chance of you getting what you want. There is always a risk of having to go open, but some surgeons might be more adept at doing it. As for the comment the person who had the band made "You will never find someone with the band asking for a revision 3 years later..." That person is absolutely dead wrong. There are many many folks who get the bands who convert to RNY, so don't be fooled. This isn't to sway you one way or the other - you choose what is best for you. But don't be fooled into thinking one procedure is perfect for everyone. They aren't and that is why you will find people who aren't happy with their initial results in EVERY type of surgery performed. And you will find those who are the biggest proponents as well. Take it all with a grain of salt and open your eyes to the full realm of good and bad in all of them before making your final decision. As for the scar of open - already touched on, but yes, if you get a tummy tuck it will pretty much eliminate the scar of open yet create a new scar. I had open and my scar is super pale. The issue for me isn't the scar - it's the flappy skin. LOL. Dina
   — Dinka Doo

December 27, 2005
The scar is not that large, once it heals. Also, he may be able to complete the surgery LAP. I would choose RNY over Lapband due to receiving "two tools in one". Restriction and malabsorption..........the reasons RNY is a more sucessful weight loss and weight loss maintenance tool, statistically. My friend had Open and I had Lap RNY.....similar recovery time. She has one scar, from breast bone down about 3 inches. I have six scars .........the smallest 1/2 inch and the largest and inch.
   — LauraA

December 28, 2005
Definitely get a second opinion. Also, sometimes what we want is not always what is best for us. I can not have DS or RNY because I have a rare form of cardiomyopathy. My cardiologist and pcp will ONLY consider allowing me to have lap-band, because it is the least invasive. So don't get all wrapped up in everyone's opinion, listen to your doctors and when in doubt get another doctor's opinion. Good luck.
   — misschrissie67

December 28, 2005
I would personally choose the DS surgery instead of either of the others.... But, on the OPEN issue...Cosmetically speaking the very fine light color scar I have (surg 7 months ago) - is awesome and looks SOOOOOOOOO much better than being so FAT. My scar is approx 7 inches...and they used dermabond skin glue instead of staples....I love it...Plus the doc can see really good and get his hands in there...another plus. Good luck.
   — T S.

December 28, 2005
The decision of which surgery to make should not be made based on cosmetic concerns like the scar. I don't know how much research you've done on the different types of surgeries and what is indicated for each, but it might be a good idea to do more. There is no guarantee that the Adjustable Gastric Band can always be placed laprascopically, either, the nickname "LapBand" notwithstanding.
   — Jeanie

December 28, 2005
I had LAP RNY last Dec- 04- I did not have gas pains. I would have been able to return to work within the week- but I had alot of sick time coming so I took it and enjoyed it! Why on earth would anyone agree to have an "open" when the LAP is so much simpler and safer is beyond me. All that suffering with that horrible open incision??? I had 2 open laps for other reasons years ago and the pain and recovery is awful. I was thinking I would have alot of pain from the LAP RNY- but nope- a piece of cake! Usually the less experienced surgeons only do opens. NOT A RISK TO TAKE! GET A BETTER SURGEON- if you are in south Florida- go to my surgeon, Peter Tomasello- he has 100% success record. NEVER had a leak, an infection or a death!!!!! I really had a quick recovery and no ugly scar. And oh yeah- I have lost 100 lbs.
   — Dec16-04




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