Question:
What qualifies a person as a good candidate for a lap RNY vs. an open and why?
I have a consultation w/a surgeon 9/26 and he performs both types. I've read a lot of postings and it seems that most people say that dr's prefer open. I would prefer the lap only because of the recovery time. — Anna B. (posted on August 21, 2002)
August 20, 2002
Every hospital is different. I will tell you that where I had my surgery
performed you needed to have a BMI of 40-45 and be a woman to have the
surgery performed LAP. They can not perform that type of surgery on the
larger group of people. Also, you could not have had any previous
abdominal surgery. (although I did have a lower c-section birth incision)
In Boston I have a friend who was a bit larger and she qualified. I prefer
LAP over the open. I am 4 months post op and barely have any scars to look
at. The recovery time from surgery is 3 weeks instead of 6 . I felt
blessed that I qualified and was able to have this done LAP. I think
without the large scar it leaves me feeling a bit more "normal"
if that makes any sense. GOOD LUCK!
— Kristy -.
August 20, 2002
it all depends on the surgeon, their experience and OR equiptement. Lap is
higher BMIs require longer expensive tools. One big advantage of LAP over
open is the near zero chance of incisional hernia. 30% of OPENS get a
hernia requiring a follow up surgery.
My wife Jen who start BMI had LAP, it took 1.5 hours. So LAP isnt
necessarily a longer procedure than open...
— bob-haller
August 20, 2002
Her start bmi was near 60. Her surgeon said she had a 15% chance of ending
up open because of her BMI. Or sugeon does LAP on those with multiple
previos abdominal surgeries as well...
— bob-haller
August 21, 2002
Anna, I had my surgery open. I am 6 days post op. I have a 48 bmi (5'5
and 290) and was given the option of lap or open. I am also more pear than
apple shaped. I chose open b/c I wanted to be under less time (open is
generally 45min - 2 hrs), where lap is longer. Ask the dtr how many he has
done of each. Also, ask your ins carrier, certain ins carriers only cover
open, not lap (since it is newer)...oh, by the way, i was up and walking
the same day the lap patients were. I had only one drain, they had 2 and
my incision.....its less than 4 inches. Good Luck.
— heathercross
August 21, 2002
I have to say that I have heard that you are under longer with lap, but I
believe it depends on the surgeon. I was done lap with a BMI of over 55
(pear shaped) and I was only under for 1.5 hours. That is shorter than
most. I would suggest you having a heart to heart with your surgeon and
see what his statistics are. I should also mention that I had no
complications, was out of the hospital in 2 days and was back to work in a
week. Good Luck and God Bless!
— Beffy W.
August 21, 2002
Anna - I asked my doctor about lap vs. open during my initial consultation.
What he told me was it depends on how "thick" your fat layer is
over your abdomen. If your fat is fairly evenly distributed over your
body, you are a probably a good candidate for lap. He said to think of it
like a see-saw - the lap instruments are like the plank and your fat is
like the fulcrum. The thicker the fat/fulcrum, the less room for movement
of the instruments/plank.<br>The doctor did a physical (basically
mashed on my abdomen) before he made the determination. Best wishes on
your journey - Joy
— Sue J.
August 21, 2002
My surgeon prefers lap and did it for me with a BMI of 63! He said it
depends a lot on if you've had other surgeries that may have left scar
tissue inside.
— jen41766
August 21, 2002
My Surgeon told me that Open RNY is still the best choice (it's the
original) over lap..more long term success he said.
He also told me that it's a better choice for people over 300lbs versus
those who weigh less b/c we have sooo much to get rid of...Please no one
get mad at me, this is what my Surgeon told me..he is also voted as one of
the top Surgeons in my state...I had an open RNY on 7/15 and have lost
40lbs. in less than 5 weeks.
— Trish R.
August 21, 2002
As I'm sure you are seeing from all of these great answers.. every surgeon
is different. Some are very skilled a lap some are not, some prefer one
over the other for various reasons. My surgeon does three different
surgeries.. and she does them ALL lap, no matter what a persons BMI. So
perhaps when you are meeting your surgeon you can talk with him about which
he prefers and why. Just remember that this is about YOU and not about your
surgeon's comfort level.. make sure you get answers that satisfy your
questions. It's important to have complete trust in your surgeon.. good
luck :)
— Joscelin
August 23, 2002
Anna, your surgeon should be able to tell you his/her criteria for lap
verses open. Factors include the surgeon's skill, length of instruments,
and the weight limit on the hospital's table as instead of your organs
being moved around as in the case of open surgery, with lap surgery the
table is moved all around in order for the surgeon to get behind organs,
etc. My surgeon wrote a manual teaching other surgeons how to perform
laproscopic procedures; he has only had one RNY surgery that had to be
converted to an open procedure. At the time of my Lap RNY, my BMI was
81.0, and I was 13 lbs shy of 500. I'm 14 months out and doing very well!
= D
— CaseyinLA
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