Question:
Every one I talk to has a different opinion, even the Doctors. Help!!
Lap or Open? — Joan R. (posted on May 16, 2003)
May 16, 2003
Joan,
It'll be a personal answer, I chose open, after doing almost 1 year of
re-search, I figured at least at the time this is what was stated, With
open you run the risk of more minor complications, and with Lap, you run
having more major complications, I chose open, sure I have a scar about 6-7
inches, but hey it's my battle wound, tells me where I've been and where
I'm going........
You'll make the right decision,
Hugs,
Post op 12 months down 130 pounds
— tannedtigress
May 16, 2003
I think that it depends on the experience of the surgeon. As Lap is
performed more there will be fewer complications. There is a learning
curve .
— Karen W.
May 16, 2003
Joan,
Unfortunately, I am able to answer this question better than most people.
I have had (kind of) both procedures. I had the LAP on Dec. 16th 2002.
About 6 weeks later I had an abstructed small intestine due to scar tissue
and had to be opened to get it repaired. I can tell you without a doubt,
if you can have the procedure LAP, do it. The recovery time was much
faster...about 10 days to feeling pretty great. It took me atleast 6 weeks
to get over the open and it was very painfull. With the open procedure I
had 36 staples and the scar is truly discusting. With LAP, you could
hardly tell that anything was done. Either way, the surgery is worth it.
It has changed my life.
— Jane S.
May 16, 2003
Like the previous poster, I've also had both, under somewhat the same
circumstances. My original surgery, in May 2002, was done lap. I had to
have a second surgery to correct a problem in July and that was done open.
Unlike the previous poster, I didn't have much pain with either procedure.
I was able to be up and walking very soon after both and healed pretty well
from both. I think the biggest factor is to find a surgeon that you are
absolutely comfortable with and have complete trust in. then go with
whichever that surgeon is most comfortable with. There are some pros and
cons to both procedures, but the most important thing is that both lap and
open involve the same procedure internally. Whether you have it lap or
open shouldn't have any bearing on how much you lose or how well you do in
the long run, and that's really the whole point.
— garw
May 16, 2003
I met with a surgeon for a consulation in April and I asked him the same
question even though he only performs Open RNY. He told me that he had
went to a seminar recently where they explained the EIGHT different ways to
do the surgery LAP. He felt that if they still have eight different ways
to do the surgery then they have not found the best way to do it yet. That
worried me safety wise. However, obviously plenty of people have the LAP
procedure performed and are fine...but it was a big consideration for
me...good luck with whatever decision you and your doc make!
— Jody R.
May 16, 2003
I had open RNY on 4/9/03. I was completely off pain medication in 5 days,
sleeping on my side in 7 and driving at 10 days. Would not change a thing.
Quite honestly, the gallbladder I had done lap was a bigger pain in the
butt. As my doctor said, the lap methods keeps you under anesthesia much
longer and tends to give you a slightly bigger pouch size. Keep an open
mind and evaluate all of your options.
— Diane B.
May 16, 2003
This is the endless argument! Every surgeon and patient believe completely
in what they are doing. It is ALL about the skill of the surgeon!!!!!! I
believe if you have an awesome Lap surgeon then there is no benifit to open
surgery! I had Lap and it took ONE HOUR and TEN MINUTES! Not longer than
open and my pouch definitely started at an ounce not bigger. Limits on
activity and risk of infection were the 2 biggest deterents for me with the
open.
— Carol S.
May 16, 2003
Depends on your size. As a super morbidly obese person, I know that for
the doc to stick a trochanter into my gut and pull it out during a lap
would have put me at risk of damage that the doc wouldn't be able to
visualize. Having the open DS, the doc was able to see the entire field,
measure out the correct amount of intestines, visually inspect all my other
organs and I had NO complications, except a hernia I got 18 months later
lifting my 225 pound legless father from his bed to his wheelchair. Whose
to say I wouldn't have gotten a hernia anyway? I personally prefer the
open procedure on people over 300 pounds. That is my opinion...
— merri B.
May 16, 2003
Open puts you at risk of a incisional hernia. Lap that risk is near zero.
If you dont mind more surgeries pick open. Results weight loss wise are the
same.
— Sam J.
May 16, 2003
I've had both done - My BPD/DS was done laparoscopically. The reason I had
a strangulated internal hernia about two years out was due to the
laparoscopic surgery! It is a very RARE complication but happened because
the surgeons didn't realize they should hand sew the lap portals (the
surgeons at Mt. Sinai practice have been doing this since but I'm not sure
about others). The minute holes that were in my mesentary (the intestinal
lining) got larger as I lost weight and - voila! My intestines got caught.
I had a second open surgery to repair the hernia, remove about 5 feet of
my diseased intestines and also re-do the BPD/DS since a part of it had
been removed. My recovery from the open was extremely painful for the
first 4-5 days. I can't really compare both because the lap (which was
quite uneventful) was not an emergency surgery as this open surgery was (I
required about 6 blood transfusions). I would say the open procedure has
about 2-4 more daysof recovery over the lap. Now, I have developed TWO
incisional hernias at 5 months post-op! I was at a totally normal bmi (21)
when I had the open surgery. I have to have another hernia repair surgery
in July. I think the stats are about 10 pct of post-ops with an open
abdominal surgery (Of any kind) will develop incisional hernias. For
internal hernias (much deadlier and more difficult to diagnose), I think
it's about 3 pct but my surgeon's office commented that it seemed higher
than that given the patients they had seen with this complication.... All
the best, Teresa
— Teresa N.
May 16, 2003
Laparoscopic surgeries have been around for a relatively long time now, so
if you have a surgeon who does lap surgery , and he/she does the procedure
you want laparoscopically, then go that way. if your surgeon prefers open,
and you are comfortable with that surgeon, then have it done open. In my
case, my surgeon is an assistant professior of surgery and the head of
endoscopic and larparoscopic surgery at a major teaching hospital, so I had
no problems at all having RNY done lap. I needed to be up and around
pretty quickly, and I was able to go back to work on the 12th day after
surgery. (I did have the option of going to 4 other surgeons who do it
open). One is not ultimately better than the other; it mainly depends on
what is available to you and how comfortable you are with your surgeon and
how he/she does the surgery. There is really no "one is better than
the other answer' to your question - only different opinions, as you have
read here.
— koogy
May 20, 2003
Joan, I had LAP RNY. I'll just say that my choice was more on the personal
side...not because the surgeon I chose specializes in LAP RNY. I'd had 4
C-sections (one of which was a miscarriage) I didn't do very well at all
with my "guts" open. (This was when I lived in Indianapolis,
Indiana) Too much trouble for me with packing, infection, staples, etc...I
literally felt like I was going to die.
Anyway, the best part, IMHO, is that after a LAP RNY, you can pretty much
return to work in 10 days to 2-3 weeks. Pain is minimal. No need to worry
about staples being removed. I lost about 30 lbs in 2wks. That may not be
much to some, but to me the weight began coming off fast. As you have
probably heard...everyone has his or her on opinion, BUT the ultimate
decision is between YOU and your surgeon. I just decided I did not want to
be limited to one type of surgery. Also Joan, another thing you might want
to do is your own research. Make comparisons. That's what I did. Ask your
surgeon for some names and phone numbers of some of his former patients
(sometimes it may/may not be possible if the patient does not authorize him
or her to divulge any information about the patient). When or if that
happens, then you have nothing to go on, and it's back to sqaure one. Feel
free to check out my profile~ I researched for 3 years!!!LOL. I listen to
some and threw some ideas out. I had to do what was best for me, and I did.
Quite happy about it too. Check out your states licensing board to make
sure your surgeon is legitimate. I have six pages of questions I asked
mine. Go to the ASBS.org website. I was told that if the office staff was
not respectable towards you, then not to bother with the surgeon. I'm not
sure if that is altogether true since I hit the jackpot with my choice. You
might want to see some of the other posties' respond. Didn't mean to write
a "book". :) Hope this helps! LAP RNY 9/3/02 265/160/115-126.
— yourdivaness
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