Question:
Surgery March26th,2003 Lap VS Open for me
HI everyone I am 5ft2 and 456 lbs. I have alot of comorbities as most of ya'll do. Well my surgeon is going to start out to try to do an LAP on me but gave me an 85% chance that hes going to have to do it openly anyways. My thought is am I just safe to tell him lets just do it open from get go??? I dont want him to start out doing it Lap and something to go wrong at my weight and all. Then to do it openly because thats alot of healing to have to do.If I dont have to have all of that I think itd be best to just do it open. Anyone have any thoughts on this or have been there ???? Please post and help me out LOL Thanks Regina McManaway — SouthernroseNsc (posted on March 4, 2003)
March 4, 2003
I would try for LAP, some 30% of opens develop at lest one hernia that
usually requires a additional surgery to fix. In LAP that incisional hernia
rate is near zero. LAP has less pain, faster healing, and with less pain it
should be easier to get up and about more. Walking greatly reduces the
chance of bloodclodts, a killer after surgery.
— Sam J.
March 4, 2003
I too was in a quite similar situation a few months back (please check out
my profile). Of course it is a decision you must feel comfortable with,
but I tend to agree with you that open is the better way to go given the
circumstances you describe. I too have a high BMI, and I just feel better
knowing that the surgeon can see things more clearly because of my size and
the fact that I want to get in and out of surgery asap. It is my
understanding that the less time you are under anesthesia, the better.
Besides, LAP might help your wounds heal faster on the outside, but inside
healing is the same whether you are open or lap. Just my thoughts, hope I
was able to give you some points to ponder! Best of success to you! You
will be in my thoughts!
— [Deactivated Member]
March 4, 2003
March 26th is my date too!!!!!!!!!! Anyway, If the Dr. can do it LAP, it
would be easier on you - just a few small incisions and not the large one
thru muscles. But it comes down to what the surgeon can safely perform due
to the layer of fat we have also. Our safety IS the most important thing -
and he has almost told you he thinks Open is a strong possibility. I'd be
prepared for that. Good Luck - I'll probably not be thinking of you while
I'm under too but have a great journey. Sally, Harrison, MI
— Sally P.
March 4, 2003
Ahhh the ole question open or lap. LOL I always see those wanting
lap..reasoning being not wanting a hernia a hernia *LOL* for me I would
rather suffer a possible hernia down the road and have that doctor open me
wide to check out all the site. Surgery time is reduced on open..why?
Cause they can see better so they do a faster job... Last WLS I had they
found a tumor on my liver when doing open. You bet I want open (revision)
It just may save a life in another way down the road! Rather suffer a
possible hernia .. Good way to get insurance paid for (HERNIA)later ...
than a possible nipped bowel or other organ during lap with those tiny
holes and not find out till its leaked all over and messed those insides up
good... ahhh just my 2cents tho :o) happy journey!
— WLS_Deb
March 4, 2003
It's no big deal for them to convert from LAP to open, so if he's willing
to try start with the LAP. That is of course you are self-pay, since LAP
is more expensive and if it's likely to be converted to open you don't want
to have to pay for sterilizing the LAP instruments etc.
<p>However, now that I have written that really one of the bigger
issues is the length of time you are under anesthesia. It is always longer
with LAP but someone in your situation (short, SMO and lots of co-morbs -
I'm not trying to mean here just stating the facts, which applied to me
also - except the short) the longer you are under anesthesia the greater
the risk. Usually opens are 1-1/2 to 2 hours. LAP's can sometimes run as
long as 5 hours. So based on that it's probably in your best interest to
go for the open. They can see what they are doing and get in and out
faster getting you off of anesthesia.
<p>I really wanted LAP also but my surgeon stood firm that he would
not do me LAP because of my BMI. I am 5'9, 421 lbs and BMI of 62 day of
surgery. When I initially saw him I was 432 & 64 BMI.
<p>As far as getting moving it won't matter if you have open or LAP
you WILL be up and walking. Yes it will hurt way more to get out of bed
but they will force you out. My surgeon requires within 2 hours of surgery
we are out of bed. Let me tell you it will take me a long time to forget
how much pain I was in and how bad it hurt to get out, but I made it. By
the time I left the hospital the nurses said I was way ahead of the game in
being able to move and get up and walk by myself etc. I walked out of the
hospital pushing my cart of stuff with the nurse pushing the wheelchair
with my mom in it, so that they met hospital requirements. So even if it's
an open it can be fine. I am a few days over 1 month PO and I still have 3
small holes (almost only 2 now) in my incision that I have to pack twice a
day, but it really is no big deal. I wish it was healed up but as long as
it heals good eventually I'm fine with that. It's a tough decision but in
your same situation I would probably just go forward with the open,
especially with the odds your surgeon is giving you of converting to open.
Good Luck! Chris
— zoedogcbr
March 5, 2003
I have had both, within two months of each other. If I had had the open
first, I would probably not have needed the second surgery. But the fact
is that my surgeon made a mistake with my first surgery. If he had been
more experienced at LAP RNY (I believe he is quite experienced with other
lap procedures, i.e., gall bladder removal, etc.), I might not have ever
needed the second one. It really boils down to what your surgeon is better
at and what he is more comfortable doing. I had very little pain with
either surgery and was able to be up and walking soon after both. There is
not one 'right' answer for everyone. I think if you feel more comfortable
in having him just plan for an open, go ahead and do tell him that. The
most important thing is having the surgery, right? In the long run, your
weight loss will probably be the same and that's what the whole thing is
all about.
— garw
March 5, 2003
— Jonathan F.
March 5, 2003
Joni, I have had WLS 12yrs ago.. how long before I can post again on the
WLS subject? hmmmm?
— WLS_Deb
March 5, 2003
Hi, Good Luck with your upcoming surgery. I am 3 weeks post op from open
RNY and doing just great!! I was off pain meds in five days, walking a
mile on the treadmill in 8 days and back to work in 14 days. I would
suggest open RNY because of less time under sedation. If your surgeon had
several hundred LAP procedures OK but if he suggest there is a possibility
of switching to open, I would do open right from the get-go!! See you on
the other side. By the way, down 35lbs in three weeks!! -- Unbelievable
and love it!!!
— Michael K.
March 5, 2003
Welp I feel all Ejucated now. here's what I have found. the "mess
leaking thingy" i was talking about *pauses to picks teef* is called
Abcess... ya know...I think eyes could get a definition if ANYONE wants
one? now that little abcess has kilt some folks...yep check it out..
http://www.fresnobee.com/bypass/story/1393892p-1468000c.html May 27th date
well thats what death the certificate read anyway...said was that it was a
leak thingy but hey .... also check out our library here typing in words
like "abcess, leak, kinks, twisted". can i post again
sometime..huh huh? Now about those Hernias... I found when I typed in
hernia that ..golly if its the patient that caused those things...ya see
your suppose to NOT lift more than a few bags of tators... for awhile... I
think some folks bags of tators must be heavier....but it appears that its
the patients fault for not following that ole docs advice.....hmmmm now I
think lap is great..if you feel comfortable with it..but I stand behind
what I said.... and how i said it.. im a foreigner ya see and we texan's
just talk a might different than others.... excuse my slang~poof!
— WLS_Deb
March 5, 2003
Joni- maybe you could use a little reeducation yourself-
LAP vs OPEN is a very personnal choice, but what Deb said is TRUE- the leak
rate is HIGHER with LAP-and can be a longer surgery, it does NOT just
depend on the skill of the surgeon, it depends on the patient. Plus, my
friend had surgery at the WORLD RENOWNED ALVARADO CLINIC (like Carney
Wilson) so it was no shabby hole in the wall hospital, her gall bladder was
horribly diseased, causing pain, but because she and her surgeron insisted
on LAP they were unable to get to it due to the length of her LAP
procedure- so consequently she had to go in recently to have her
gallbladder removed and they found a scar ahdesion that was like a ligament
wrapped around her bowel and across her abdomen, caused by the manipulation
of the tissues during her LAP procedure-
So I am not advocating one over the other, as I said it is a personal
choice, that only Regina and her doctor can make. I had open for preciclsy
the same reason as WLS DEB,open me up, spread my guts around, do your thing
and put me back together. I have not had a single conplication or problem,
no so much as a twinge. SO for me the choice is obvious!
— ~~Stacie~~
March 5, 2003
1. Go with what your doctor does best.
2. My dr won't do lap surgery because at my weight which is close to yours
and I DON'T HAVE A LAP. Seems to me you would have to have a lap to have
lap surgery. Guess you have one huh!
3. Take the flames to emails and just answer the ladies question. Actually
I think she answered her question. He is probably going to do open.
4. The only true bottom line difference is cosmetic Little vs big scar.
Once you get a TT that scar will probably be neglible. I had open three yrs
ago and you can barely see mine. LISTEN to your doctor
— snicklefritz
March 5, 2003
Its really up to your surgeon and best if they are highly experienced LAP
surgeons. My wifes over 60 BMI was done LAP in 1.5 hours. Although becauise
of her size she was at about a 10% chance of being converted to open. The
time to decide this isnt weeks before surgery, its when your shopping for a
doc. Insurance pays for the much costlier LAP procedure because the
expensive hospital stays are shorter. Me and Jen were both just 2 nites and
now some go home after a day and a half. <P> I recommend you go with
what your surgeon feels mst comfy with and others consuidering surgery
decide this BEFORE making a final surgeon selection.
— bob-haller
March 5, 2003
What a intersting discussion. I have a friend who got a hernia. He sneezed
and that is what his doc figured caused it. Says no matter how close you
follow the no lifting rule its still possible to get one or more. He has
suffered thru 3. Seems the cut stomach muscles never really are as strong
after surgery as before.
— Sam J.
March 5, 2003
Well Joni, guess YOU dont have to educate yourself in how to make mean and
degrading comments :) BUT you might want to educate yourself on the fact
that all surgeons are different. ALSO, not all laps are that short. In fact
the surgeons office I contacted personally said the LAP time is about 4
hours. I know some of us really feel like we know everything there is about
WLS and what goes with it, but I have found that there is still a lot out
there we can learn. I also believe that open is better for
"finding" things that might be over looked with a lap, but only
because with a lap the surgeons are looking at a particular area. Has
nothing to do with how good they are. If a person is open, a doctor cant
help but see what is before him in plain sight. <p> Please, please be
kind to your fellow AMOS member. If we can't be kind to each other how can
we expect "others" to be kind to us?
— TheresaC
March 6, 2003
AMOS MOD HERE. Please BE NICE! Were all here to learn and help and support
one another. I understand surgeons have similiar disagreements. Now
everyone take a deep breathe and BE NICE to one another or we will be
forced to start removing responses....
— bob-haller
March 6, 2003
Hi all, I am so sorry that this question has caused all of these
disagreements among our brothers and sisters here at obesityhelp. I
appreciate everyone who has posted and tried to help me but I guess the
final decisions will bebetween Dr Scott and Dr Schirmer and me.I was just
wondering if anyone else had been through what Im going through with the
amount of BMI I am at and weight.I do have alot of comorbities such as
Diabetes, sleep anea, hypothyroidism, polycystic ovarian syndrome,chronic
venous insufficieny, (meaning the blood doesnt flow sufficiently in my
legs,)high blood pressure,high cholesterol, and depression , anxiety, and
on top of all of this my right ankle had collapsed and the bones have grown
to the right in my foot and excess bone has also grown ,there is no
cartilage the osteoarthritis has eaten it away. Therefore I am worried
because I am afriad of getting blood clots due to my immobilty issues. I
can barely walk a few feet so my legs have gotten very weak. I use a
scooter that I bought last year to go shopping and things that otherwise I
cannot do. So that was why I was asking Lap VS Open and what would be best
for me. Thanks to everyone here at the site and please the most you can to
be helpful is pleaseeee keep me in your prayers . May God bless ya'll.
Regina McManaway
— SouthernroseNsc
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