Question:
Pros and cons of having the bypass done laparscopically
Being that I am only 24, I decided to have my bypass done laparoscopically (less scarring, I'm told) and my doctor only does it that way and raves about it. Well, I know a lady that had the open incision and she is trying to discourage me from having it done laparscopically, telling me that there is more chance of infection, more leaking and other bad things like that. I just wanted to know if this is true or not, and is open better than laparscopically? Also what are the pros and cons of laparscopically? — mommajenn (posted on March 24, 2007)
March 24, 2007
Well it has been almost one year (4/18) since I had a lap RNY- I am 59
years old- no complications- my program prepares you very well- 10 weeks of
2 hrs each week of classes to prepare, being followed by an dietitian and
psych preop, and at least one year of monthly support group meetings (all
mandatory to have the procedure)- I knew what to expect and how to respond-
my doc thought I would only get down to about 165# but I am 138#- What will
happen in a year or two- I am not sure but I am pleased with the results
and feel positive I will keep it off and speaking as a nurse I know that my
attitude is a major accomplishment- my best advice is don't let the turkeys
get you down- my own sisters tried to tell me I was silly to do this but I
feel differently- Donna 5'6" 286/138
— dabby
March 24, 2007
is that lady on psych medication? why in the world would she discourage a
less invasive procedure as opposed to having your entire front side
literally split in 2? There is a chance of infection in any surgery but
geezzzzzzzzz lap is so fine tuned these days the risk is minimal.With lap
you have very few scars, i think 5 half inch or less. I just cannot believe
that lady trying to scare someone with so many untruths. Sure, sometimes
unfortunate mishaps occur to some people but gosh the # is so small. I
would have to advise you to go to webmd or just do a google search yourself
and look up rou-en-y gastric bypass... i'm sorry i'm just floored that
someone would advise so negatively and incorrectly.
— _blue_
March 24, 2007
Jenn... I don't know what the lady you have been talking to is basing her
beliefs regarding the open vs lap on. The lap method is far LESS invasive,
has a lower infection rate due to the smaller incisions. There is less
leaking with this method, as well. The surgeons, because they are using
computerized instruments are able to see better, employing the use of
computer magnification that with the naked eye, thus less of a chance of
leaking. They are able to due the microsutures that you wouldn't be able
to do with the naked eye. My surgeon, as well as all surgeons do the open
RNY, as you will have to sign a consent for the lap rny with possible
laparotomy, which means if they run into complications, you give them
permission to use the long incision. This is only employed when starting
lap if there is a puncture to the bowel, liver, etc - which is also a
potential complication of an open incision. Or if there is so much scar
tissue from previous surgeries that makes it impossible for them to free up
the bowel using the lap method. Tell the person that you have been talking
to - to research all before she starts giving advice to others. I am in
the medical field (ER nurse) I researched this for many months, as well as
talked to several surgeons. They ALL favor the least invasive method = the
lap method. If you have any other questions... speak with a medical person
or surgeon.
— Kari_K
March 24, 2007
— donnyj53
March 24, 2007
Jenn,
The pro for me LESS PAIN! When they cut you wide open there is pain and
your mobility is going to be limited. When I had to have cysts removed from
my ovaries the surgeon tried to do it lap and ended up cutting me open --
that was about 5-6 years ago and now I realize he didn't know what the heck
he was doing.
I'm almost 5 weeks out and have been moving since the day of surgery. I
didn't need any help sitting up or getting out of the bed. With an open
incision, you will need help sitting up and getting up -- depending on your
tolerance for pain. The only pain I felt in my stomach was as if I'd been
doing situps. When I thought I was having stomach pain it turned out to be
gas. As far as leaking, my surgeon puts a drain in his patients that you
continue to wear for a week after you are discharged from the hospital.
During that time I had cramps every once in awhile and that was because the
tube for the drain was moving. If the pain gets too bad you can call the
surgeon and they will take it out. It wasn't bad -- just irritating that
it was there.
Maybe that was just her preference and she might not trust the new methods
of surgery -- but she had more chance of getting an infection that people
who have lap ever would.
— the7thdean
March 24, 2007
If RNY wasn't available lap I wouldn't have done it. Who wants a full
incision and a longer recovery time??? When I needed a hysterectomy I
researched until I found a doctor who would do it via lap....my recovery
was half of what it would have been the regular way! Lap is the way to go,
don't let anyone tell you otherwise! I had absolutely no complications
from the incisions and they healed nicely! Why would you want a scar when
you put on a bikini????
— Sheri A.
March 24, 2007
It is a wll known medical fact that the less invasive a procedure is, the
less chance for infections, or any other complications. I'm an RN (33 yrs),
and I had my laproscopic RNY July 3, 2006. I had no complications with the
small incisions; in fact, my surgeon is pleased that they are barely
visible.
If anyone gets an inection, which I'm sure there may be a small percentage
that do, it is NOT because they had the lap, but it was caused by other
forces. Usually the patient has not followed suggestions regarding stitch
care, or the surgicl team is grossly inept.
And why would this person tell you such a horrid tale?
My dad had the original duodenal/jejuenum bypass at UCLA. That'swhere there
is a large incision down the front, and the recovery is much slower, and
there is a 80-95% chance of infection. Thank God my dad followed his doc's
orders and he didn't have complications.
But, again, why is the lady being so negative?
Talk with your physician, and nurses. Check out the infection rate at the
hospital (by law hospitals have to keep records on infections. Ask your
physician if there are any patients post-op who could give you information
and support.
Attend the educations classes offered by the hospital, and hopefully, there
are staff in the surgeon's office who can offer you information as well.
Good luck.
Peace, love, health and happiness.
Dana
— Dana M.
March 24, 2007
My doctor refuses to do lap - he's just old school. I didn't mind because
I was willing to do anything to have the surgery. All I can say in favor
of open is that when the surgeon is able to go in and actually open you up,
he's able to see things that you can't with a camera. He inspected all my
organs first-hand while he was in there. I was 300# and pretty unhealthy
so I liked that he gave me a "check up" if you will. But lap is
fine. And yes, I have a scar but it's healing quite nicely. And I may
have lost 146# in a year but there's no way in hell I'm getting in a bikini
so it doesn't matter to me! LOL. Whichever decision you make, you'll be
fine. Don't listen to that lady...do your own research and speak with your
doc. Brightest blessings. ~Sarah in VA
— platypus
March 24, 2007
The risk of a hernia postop with an open is grossly higher than those done
lap. Open cuts the entire rectis abdominus(spelling) muscle where lap pokes
a few holes. More surgeons wouldn't be doing it lap if open were better.
— tazthewiz23
March 24, 2007
She sounds like a relative of my husband's. If she could not have it done
the better way then she does not want you to be able to. Bottom
line.........if you trust your doctor and have done your research on this
surgery you will make the right decision for YOU. I had it done lap and it
was a very easy recovery. I can't imagine if my doctor had done it open. It
would have been very hard just to get out of bed without worrying about
pulling or tearing something open. You do what is right for you and good
luck to you!
— CAMFR
March 25, 2007
For me.... LAP is the only way to go. WHY would I opt to have my body cut
open down the middle when I could have a few little scars? HUM? You, like
me are younger (you 24, my 35) there are still plenty of summers I'd like
to wear a swimming suit w/o looking like the bride of Frankenstien - not
saying I would ever wear a two piece - but you never know what the future
holds for you. My mom's been cut open 3x for other procedures relating to
the stomach and intestines - it's not fun, pretty or painless. She
developed a hernia the last time. Personally, I wouldn't have done the
surgery otherwise. I had a laproscopic surgery done in 95 when I had my
gallbladder and appendix out - if that was the going to be the worst I
would feel. ... GREAT! To tell you the truth, I recovered from LAP/RNY
quicker than I did from the galllbladder/appendix removal. The 1st week out
of the hospital I was running errands (granted my mom and fiance' drove)
but I was at the grocery store, going to the fabric store to get things to
keep my hand busy while at home......it's entirely up to you, but this girl
opts for anything that is less invasive and less painful and leaves less
scars on my bod. That's just me. Ultimately, it's your decision.....sounds
like you've already got it made up - don't let others deter you from making
a decision you are already OK with ;)
— jammerz
March 25, 2007
LAP way to go! Less pain, less infection risk with open room air gets
inside your body cavity, room air has nasties:( In lap your insides are
filled with sterile nitrogen. Most important about 1/3 of opens get at
least one incisional hernia because the muscle wall is cut, LAP the rate is
near zero:) With lap less pain equals your up moving sooner, which helps
minimize risks from stuff like blood clots....
— bob-haller
March 25, 2007
Hi Jenn, and thanks for your question. It is a big question indeed! You
have to research the two types of surgery for yourself, get on line here,
buy books, and talk to your doctors. All this input is important, for you
to decide. Having said that to you, let me now say this. There are pros
and cons to every surgery. I don't think there is a higher risk of
infection or most of the things you mention with a lap proceedure as
opposed to open. There might be more risk for leakage, as you would be
wide open to test for leakage on the open but not for the lap, so that risk
might actually be higher, but I don't think by a lot. What really matters
here is the experience of your surgeon and your research. If your surgeon
has done only a few lap proceedures (less than 100), then I would seriously
look for another surgeon. Experience is really important here, so are
their credentials. They should have credentials that qualify them in lap
proceedures. At our hospital where I had surgery, they do a number of
surgeries for wls, so since they do them all, we had training on all types
of surgeries to choose from. They have the experience and training to do
them all (and have several surgeons to choose from). I find though, that
some surgeons key in on a certain type of surgery, that is what they
promote and other surgeries have "more risk", "more
complications", etc. They see it that way because they don't perform
these proceedures, so therefore there really is more risk due to that fact
alone. Your friend, to me sounds like she is in that camp. Her doctor,
perhaps, did only open surgery, so that is what he sees as safe only. This
is passed to patient, and then to fear the nearby friend thinking of a
different surgery than the friend had, producing fear and anxiety in both
parties. The cure for this problem is research, and prayer. I had lap
done. It worked well for me, no complications (I do have a gastric ulcer,
but that is it), no leaks. I am very thankful. My surgeon was a cutting
edge surgeon in lap surgery, so she knew her stuff, and took the time to do
it right. I trusted her, and had every reason to trust her. Her
experience in the field was proven. Ask questions, and don't take "I
don't know" for answers. There are books, websites and surgeons
better have answers. If they don't you need another surgeon! Hope this
helps. Take care. Patricia P.
— Patricia P
March 25, 2007
There is one advantage to having open surgery - you can have a much more
distal bypass.
That's the only one I know of.
The very distal procedures (where you know the length of common channel)
can only be done open.
The distal RnY and DS provide greater, more sustained weight loss.
— rayehawk
March 25, 2007
If your doctor only does it lap, then you should have it done lap. If s/he
didn't think it was doable via lap, I'm sure you'd be sent to another doc.
Each procedure has risks. If you are going to a doctor that only does open
surgeries, asking him or her to do it lap is most likely not in your best
interest.
I wonder if the lady you mentioned might have some kind of condition or
risk that would have made it safer for her to have an open (vs. lap) and
she assumes that applies to everyone... who knows.
I will tell you con story for lap. I had my appendix out via lap... three
tiny incisions, can't find two of 'em anymore. I was told I'd be admitted,
have the surgery, spend the night, home the next day.... instead I was
there for 10 days. Either the surgery itself or the gas they used caused
my intestines/stomach to stop working. I could not pass the gas... I
spent 2-3 hours every day walking up and down and around the hall because
that's what they said would make it better---it didn't and narcotics (for
me) do not help gas pain. I felt so horrible. Couldn't eat, wasn't
supposed to drink. Blech. I've never had open surgery but I can't imagine
it being much worse. My experience, however, is not the norm tho.
Best wishes
— mrsidknee
March 26, 2007
Lap RYN is preferred by doctors and patients because it causes less
infections, you heel quicker, and less pain. When someone is open
completely, there are more changes of bateria to get in and cause
infections. It takes longer to heel having an open ryn. I dont know why
your friend would tell you that. You might just want to discuss this with
your doctor that way you are getting the facts. Good Luck!
— barfiep01
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