Question:
Are there Size/Weight limitations to having the LAP RNY??
I am a 550 lb male and would like to have LAP RNY but heard there are size limitations because of the instruments that are used. Does any one know if this is true or not?? And what surgery might be recommended for me and the many co-morbities that I have?? Thank You for your Time and Help with this. — Randy Leck (posted on March 8, 2003)
March 8, 2003
It depends on if your surgeon has instruments long enough to reach where
they need to reach. Personally I like the idea of being opened up so that
the surgeon has a good view of what he is doing. But the choice is yours,
I hope you find a surgeon who can meet your needs.
— Sarahlicious
March 8, 2003
I was told by my Dr. that he might not be able to do it lap on me, but he
was able to...There was also a show on recently that a man that weighed
over 650 pounds had it done lap, and my Dr. said that he did it on a 600
pound patient... I hope this helps! Good luck!!!
— rebecca J.
March 8, 2003
Hello-
I will have my Open RNY surgery on 3/11. After the research I have done and
what my surgeon told me I glad it will be done open. My surgeon who is also
a laproscopic surgeon does not feel that lap RNY is technologically
advanced enough for this procedure yet. The results are much better with
open. The research I have done supports his statements. I realize that with
lap you only get four holes (I had my gall bladder removed lap), but to me
it seems that open is better at this time.
— Carissa A.
March 8, 2003
Your known as a big boy by many surgeons. My surgeon does folks like you
LAP, in two stages. The first stage is restrictive only, you loose 2 or 3
hunderd pounds then return for stage 2. The malabsorbtion part. It reduces
table time dramatically and keeps you safer. My surgeon has special extra
long LAP tools and does most of these lap. My friend bill started out with
a 74 inch waist. He is now down to 40. Many surgeons dont have the tools or
skills to do the really super MOs LAP. Pittsburgh isnt that far away, you
might check out my surgeon. Heres my surgeons support group page, I think
Bill Carettas picture is around somewhere.<P>
http://www.upmc.edu/obesitysurgery/monthlySupportGroup.htm
— bob-haller
March 8, 2003
Hi there. My surgeon will not operate on anyone who is over a 60 BMI
because the risks are too great. It all depends on the surgeon. Good Luck!
— Missy W.
March 8, 2003
Unless that surgeon had done quite a few people your size LAP I would go
for the open. I realize Bob's surgeon is offering an option that allows
LAP but there is no way I would go for two surgeries. Just when you are
feeling great and have a really active life you are knocked on your butt
for a while again. While you will likely recover sooner and with minimal
problems it's still a setback. I had foot surgery a few months after I had
been losing weight (not from WLS surgery) and was set back. Consequently I
wanted to get back to walking and keep the weight loss going so I pushed
it. One day, 3 weeks post-op, I was out walking 2-1/2 miles and felt
something become very painful. Long story short I just overdid an didn't
do major harm but the foot surgeon said keep it up and you'll rip the
achilles loose and then you'll be in a cast for 12 weeks and probably on
crutches for another 12 weeks. That was enough to calm me down, but it was
difficult to go back to that sedentary life, especially because the lbs had
literally been dropping off to the tune of 25-30 lbs a month.
<p>It truly comes down to the surgeon and their skills and the
instruments they have. The LAP can be a really long surgery, upwards of 3-5
hours, and being SMO it is not in your best interest to be under anesthesia
any longer than necessary. I also was (I guess still am at 396 LOL) a SMO
woman at 421 day of surgery. I was bent on getting LAP when I started the
process but my surgeon refused to do it on me because of weight and 64 BMI.
I thought I could convince him because I do not have tons of wieght in the
chest/upper abdomen area, but didn't work. He wanted to see clearly and
more importantly get in and out as quick as possible. I wanted this
particular surgeon so I resigned myself to an open. I will be 5 weeks
post-op on Monday. The incision has been a minor issue and I am fine with
it. I've had 3 small holes to pack in the incision but it is no big deal.
One is now closed up the 2nd one close to it and the 3rd one is still quite
deep so it will likely be another 2 weeks or so but it's not a big
inconvenience. I was in surgery for around 1-1/2 hours, way less than LAP.
I have moderately severe sleep apnea and asthma but never had any
breathing problems or other issues during surgery. The less time the
better. Only you can decide what is right for you but just make sure he
has done quite a few SMO patients without complications that required going
back in for surgery. Good Luck! Chris
— zoedogcbr
March 8, 2003
I'm probably just repeating what has already been said (too tired to read
all of the comments)....All surgeons are different- some don't even do lap
while other set weight limits with lap. My surgeon doesn't usually do lap
on those over 350lbs.- not sure of his reasons. There
<i>are</i> longer instruments for heavier patients, but not all
surgeons have them. I don't know if you have selected a surgeon yet, but if
you have decided lap is best for you, research the surgeons in your area
for the ones who do lap. I would suggest using obesityhelp to your
advantage. Look up others in your area and read their profiles. (I chose my
surgeon via this site!).....Best of luck to you!!!......Karen (lap rny- 5
1/2 mons. post-op- down 115 pounds)
— karmiausnic
March 8, 2003
Your answer lies in the experience and expertise of the surgeon....the
availability of longer laparascopic instruments and a hospital staff that
specializes in bariatric care are also critical factors. Our surgeon is
one of the founders of laparascopic WLS and has performed over 1400
surgeries. My daughter's BMI was 70 and she had a very uncomplicated and
successful lap RNY....only one hour operating time, no ICU, no tubes or
drains, out of the hospital in two days and back to work in two weeks. The
other four people in our family who have had their lap RNYs performed by
this surgeon had exactly the same experiences (BMIs ranging from 40-52).
Patients come to this particular surgeon from all over the world. He has
done lap WLS on patients weighing in excess of 600 lbs. and has been
featured with one of these patients on the Discovery Health channel. He
has comparable colleagues across the US...continue to research available
surgeons if this is a procedure that you want. The web site for the
American Society of Bariatric Surgery was a good resource for me when I was
in the decision-making process: www.asbs.org. My final thought is that I
would always opt for an open surgery if I could not have a board-certified
bariatric surgeon with extensive experience in laparascopy. It is a
demanding speciality and requires extensive training to gain expertise. If
problems are reported with lap surgery, the majority of those cases can be
attributed to lesser experience on the part of the surgeon. Statements
from surgeons such as, "laparascopic WLS cannot be successfully
performed on patients weighing over 350 lbs.", or "open surgery
is better because the surgeon can see better" or "laparoscopic
surgery takes longer than an open surgery" are misleading to patients
and strongly indicate lesser experience in laparascopy on the part of the
surgeon. None of those statements are hard facts when dealing with
surgeons experienced in the technique. It is still very important to
remember that the incidence of complications increases proportionately with
the degree of obesity...open or lap...so keep looking until you find the
best surgeon for you. Best wishes!
— Diana T.
March 8, 2003
Randy, at the time of my surgery, my weight was nearly 500 lbs and my BMI
was well into the 80s. My surgeon had no qualms about doing my RNY as a
Lap procedure. Just one surgery, and I did really well. I did, however,
spend a great deal of time researching surgeons before I found one that I
felt comfortable enough with in terms of background and approach before I
made an appointment. All the best to you!
— CaseyinLA
March 8, 2003
I know standford medical center has a rule not to perform the surgery on
anyone with a BMI over 60 they say it an operative risk. I also know
someone who went thru kasier who weighs about the same as you and had the
surgery done.
She doing well and they kept her on oxygen longer and she stayed in the
intensive care unit for 2 days after surgery then they moved her to regular
ward.
I my self had surgery and I had a whole lot of problems after I woke up.
Swelling in my stomach and a blockage problem.
— sheri B.
March 9, 2003
All depends on the skill and experience of your surgeon - s/he'll do what's
best for you and him. I had a BMI of 64 - no problems with lap at all.
— jen41766
Click Here to Return