Question:
Why do so many more people have open RNY? Isn't LAP recovery quicker?
— sandyinlex (posted on May 19, 2002)
May 19, 2002
I had the Open surgery because Lap was not an option for my insurance. I
believe that I would have gone the open way anyway because with Lap there's
no guarantee that it can be done that way until their already inside and
then you would be cut anyway if it was found that it couldn't be completed
laparcospically (spellin?):-)
— Devera R.
May 19, 2002
My doc said that open is my only option because of my 63 BMI. Said it would
be to hard to do it lap.
— chirsw
May 19, 2002
I had open for several reasons. #1 that is the only surgery my doctor does
- and I wanted this surgeon. #2 I had a bad experience after lap
gallbladder surgery. Something I felt could have been avoided if the
surgeon had been able to have his hands inside and feel things. The
recovery time never entered into my decision. I think we all have to decide
what the best option is for us and for me that was open.
— georgiacarol
May 19, 2002
My decision for Open RNY had more to do with O.R. time and the fact that
your under anesthesia for a longer period of time with the Lap. Because
I've already had a C-section and my recovery was very quick I opted to go
for the quicker surgery. Obviously we all have our own opinions and here
is my humble one. I wish you all the best with whatever choice you make :-)
— D S.
May 19, 2002
The main reason is that very few surgeons have been trained in the lap
method. I recently had it done and traveled 4 hours to find the best in
the midwest. However, the recovery has not been as quick as I had hoped.
I'm 12 days post-op and feeling pretty good now. My surgery lasted 1.5
hours with 5 half inch incisions. Sure beats a long vertical scar.
— Michelle B.
May 19, 2002
My decision to have my surgery open was because my surgeon and myself felt
more comfortable with a hands on approach to this surgery.
— RebeccaP
May 19, 2002
I think it is because more surgeons are trained in the open procedure and
less are trained in the lap. So if the surgeon doesn't know how to perform
lap, naturally he/she is going to recommend the open. Alot of the surgeons
that do open only are taking the training to learn the lap. I had lap by a
surgeon who teaches the surgery. I felt very comfortable and in good
hands.
— Annie H.
May 19, 2002
Although it is true that there are no guarantees that a lap surgery won't
end up being an open surgery in the face of unexpected problems....it is
NOT true that (a) lap surgery requires a longer operating time and
anesthesia time than an open surgery, (b) the doctor can "see
better" with an open surgery, and (c) lap surgery is not possible with
patients having a high BMI. The answer to all of these issues lies with
the experience and the expertise of the surgeon. More and more general
surgeons across the nation are jumping on the "WLS bandwagon",
but few are already trained in laparascopic surgery or are willing to
undertake the intensive training required to become proficient in that
specialty. Remember that whether a patient chooses lap or open, the work
on the "inside" is exactly the same...only the approach is
different. Four of us in our family have had lap RNY. The longest
operating/anesthesia time for any of us was mine....one hour, ten minutes.
As a critical-care RN who has assisted with lap procedures, I can tell you
that the visualization of the operative site with the lap cameras is much,
much greater than with the naked eye. "Being able to see better"
is an reason that is often offered by surgeons who do not or cannot perform
laparascopic surgery skillfully. Finally, my daughter's BMI was 69, and
she had a completely successful and uncomplicated lap surgery...no ICU,
two-day hospitalization, no tubes/drains, no problems. From my
perspective, it was wonderful to find a qualified bariatric surgeon who
specialized in lap WLS....but if I had not been able to do so, I would
certainly have researched available bariatric surgeons with experience in
the field and been just as happy with an open procedure. In the long run,
it's not so much how the surgery is done, but that the journey is begun.
It is a journey that will change your life forever. Best wishes!
— Diana T.
May 19, 2002
It IS true that the doctor can see better when they perform the open
procedure. They can explore more. While my doctor was performing my RNY,
he discovered a small cyst on my left ovary that he would not have seen had
he done the surgery lap. Sometimes it is better to have the open. I was
concerned about having mine done open, but it was the only way my surgeon
performs the surgery. Luckily, I have not experienced much pain at all.
It really hasn't been nearly as painful as I thought it would be, but I
know that everyone tolerates pain differently.
— Kristie B.
May 19, 2002
My doctor, who only does liver transplants and the gastric bypass
surgeries, will not do lap procedures, only open. When I went to my
consultation, I asked him why he didn't do them lap and he told me that
your insides (organs) heal better by doing it open instead of lap. I am
planning to have mine done open too, since I want him to do my surgery. I
think there is pros and cons to both. Good luck!!
— Judy W.
May 20, 2002
Most docs are experts at open and lap is still new. There are few docs that
have done over 200-300 lap procedures. It can be very difficult and some
insurances soemstimes will approve open and not lap, but they are getting
away from that.
— Courtney W.
May 20, 2002
How do your insides (organs) heal better by doing it open? That doesn't
make any sense. Are you sure you understood him correctly? The incision
on the tissue/muscle doesn't have any bearing on the organs.
— Cheri M.
May 20, 2002
My surgeon told me he prefers to do the Open RNY procedure, rather than the
LAP because of the time involved. He stated that Open surgery takes around
an hour, and that LAP surgery generally takes around 4 hours.
— blank first name B.
May 20, 2002
I just had to add here again. My surgeon and I chose to do this procedure
open because that is what we were both most comfortable with. It had
nothing to do with the fact that he lacked training in the LAP procedure.
The surgeon htat I chose had been doing this surgery since the early 80's
and has been a teaching surgeon for the open and the LAP procedure. He has
performed many lap procedures and has taught the lap procedure. However,
in his opinion, for many reasons, he feels the open procedure is the safest
for the patient.
— RebeccaP
May 20, 2002
I think that doctors that specialize in both prefer on lightweights to do
it lap but my surgeon said anything over a bmi of 55 he would do it open.
Also if you have several stomach surgeries that would probably have alot of
scar tissue they would have to do it open.
I had my lap and am very happy with the results and the healing time but,
again my bmi was 43 and no other surgeries. If you can have it lap I
personally would suggest it. I was back to work in 2 weeks, walking one
mile and i am now 6 weeks post walking 3 miles and feel like I never had
the surgery. except when I eat. Good luck in whatever your decision.rk
— Robin B.
May 20, 2002
Sorry I forgot to add my surgery took 1.5 hours and that included my
gallbladdar removal. So lap does not take any longer than open.
— Robin B.
May 20, 2002
I had LAP. 6 hour procedure. BMI 44 at time. My surgeon does both lap
and open - I was #8 or so for the lap procedure. I was comfortable with
going the lap route - recovery was much much shorter. BUT I was under for
a *very* long period of time, and that's with 2 surgeons operating on me
for the wls lap. I know I made the right choice, only you can choose which
option is better for you. My surgeon will not do lap on anyone over 40,
but he felt my shape and where I carried my weight would allow the lap to
be done. No complications,either. Good luck!
— Sarah C.
May 20, 2002
Well alot (or most) of us DON'T have a choice for whatever reasons. However
after hearing the pros and cons of BOTH the open and the lap, I'm VERY GLAD
mine was an Open.
— Danmark
May 20, 2002
Lap recovery is faster because theres less cuttng of muscle walls. This
also explains why 30% of opens get incisional hernias, and LAP its near
zero. <P> Lap is the future of surgery, insurance pays for it because
although OR wise it costs a bit more it saves days in the hospital and $$$.
Anything that saves pain and recovery time is GREAT for me.
— bob-haller
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