Question:
Which to do?
I went on a consult with an open doctor, he told me that, lap caused more pulmonary emblolisms because you were in surgery longer and because they pumped up your stomach. He also said the complication rate was higher and that there were more infections with the openings, and less weight loss. It would seem to be from everything I have heard lap is the best way to go, please help tell me your choices and experiences. I am ready to go. Thanks Tammy — tammy S. (posted on September 26, 2002)
September 25, 2002
Naturally he will sell HIS procedure. A EXPERIENCED LAP surgeon OR time is
not much longer than a open. My wifes Jen OR time was 1.5 hours LAP with a
starting BMI of about 60. Incisional hernias happen to 30% of opens, LAP
near ZERO. Lap has a lower overall infection rate since the entire belly
isnt opened up. The actual RNY preocedure is the SAME, its only a matter of
access, LAP or OPEN does NOT affect loss amount. Since LAPs have less pain
because theres less overall cutting, ands spend fewer days in the hospital
and are easier able to get around and walk more the blood clot risk should
be less. Your profile is private, what part of the country are you in?
Perhaps someone can suggest a great surgeon in your area. ME? 2 days in
hospital, back to work part time in just over a week, boredom was my big
problem. Lost 120 pounds in 6 months and at chart weight in 8 months 183
pounds. <P> Lets see if this will post here?
<P>
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— bob-haller
September 25, 2002
Well it did not post well but all that is the librarys list of LAP vs Open
if you put it in as a search.
— bob-haller
September 26, 2002
Tammy, that is the first I have heard of lap causing more embolisms and
more infections, and less weight loss. I can't believe a competent doctor
would give out those types of stats! Perhaps you should of asked him for
his statistics and which studies he looked at for that info! I don't know
about the embolisms but I don't believe the complication rate is higher
(open RNY has a 30% chance of hernia), and definitely no difference in
weight loss amounts with lap vs. open. You are usually on the table longer
with lap, that is true, but you have less scaring, and a quicker recovery.
I chose lap for those reasons. You may want to look around for other docs,
but I would definitely challenge this surgeon to produce the evidence.
— Cindy R.
September 26, 2002
Hi there. Just thought I'd put my two cents in here. I originally thought
I wanted Lap but changed my mind and decided on open after speaking to by
surgeon and researching. Most of what your doctor told you is not
blatently 'wrong' (except the weight loss thing) but he was clearly
advocating for an open procedure. I must stress to you that the type of
surgery can not be decided by anyone but YOU. YOU must take into
consideration all of the facts. Don't choose the lap procedure just
because you 'heard' it was easier. I personally choose open because of the
lower statistical chance of complications from leaks, infection and
non-surgical complications such as blood clots due to the length of surgery
with lap. Now, having said that, I am a statistical person- to me- the way
with technically the least complications is the best. By the way, my
surgeon does both procedures and does not 'advocate' for either as long as
you fit the lap criteria. So again- dont just choose the 'easy' way.
Educate yourself about what's best for YOU based on your BMI, where you
carry weight and your personal surgical and medical history. Good luck
with your journey!
— LMCLILLY
September 26, 2002
The safety of the procedures has everything to do with the experience of
the particular surgeon. And the studies back that up (you can look it up on
MedLine if you want). A surgeon experienced with lap WLS will have you on
the table no longer than an experienced surgeon would for an open surgery.
And the complication risks are similar. Bob is correct in that the risk for
hernia is much lower for lap than open. And some say that there is less
recovery time required for lap, although I have heard just as many lap
folks say they were down for the count as open folks say they were up and
about the next week. I think it depends on how your body and mind handle
the surgery, personally. I guess my concern about this surgeon would be
that he is not only not embracing new more advanced techniques, but not
willing to even learn the truth about them. How do you know that he will do
things according to the most current information available if he is so ill
informed? That would make me uncomfortable. Best of luck to you!
— ctyst
September 26, 2002
Like Bob said their is a greater chance of hernia with open. There is a
greater chance of leaks with the lap..Other than the incision, the surgery
is the exact same thing. I personally would choose another surgeon just
for the fact that this one doesn't seem to be quite as honest as he should
be. I am ending up with open b/c of my size..BMI of 61.7 and b/c the
surgeon I wanted only does the open...I think it is a personal thing. There
are many other types of wls and many differnt surgeons you could look into
before making a final decision. What makes you feel comfortable is the most
important thing. Terri open RNY 10/15/02
— cherokey55
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