Question:
Does the stomache

I was all excited with the decision to have the lap RNY, then I was told that the open RNY is better because your stomache isn't left "floating." With all my research, I thought they were the same exact surgury just smaller incisions. Is it really different? Is your stomache left basically "floating" with the lap? Please help!! I'm totally confused now!    — Tonna (posted on November 26, 1999)

November 26, 1999
Hi I just wanted to let u know that I had Lap done 11/22 and not really sure what u mean when u say floating? Yeah they have to pump up your stomach be4 the surgry but by the time u wake up its back down to normal (mine was anyway). Lap is so much better from what I hear. I mean u wouldn't believe my incisions. They're 4 lil holes compared to a whole slit down your stomach. Makes it so much easier to move around and heal. People look at my stomach and don't even believe that I had that kind of major surgery done. And it wasn't even a week ago. I have a pic of my incisions (taken right after my surgery) if you'd like to see them feel free to e-mail me at [email protected] Hope I've been some help to you....good luck!
   — Liza Y.

November 27, 1999
It is amazing the kinds of things that are stated to make one think that the LAP is inferior to the Open RNY. The RNY done by LAP is no different from the open surgery for RNY except that you have a MUCH more better recovery time. No large incision and no risk of hernia from a large incision. Research has shown that most of the pain and recovery from surgery is based on how large of an incision is made. That is why the LAP is so popular in the surgery field because it offers the patient less pain and less recovery time. What that means for the surgeon is that he needs to have learned the LAP procedure, which is quite difficult if a surgeon has spent his career learning to "feel" during surgery with his hands, the LAP uses instruments and camera's. The surgeon would need to learn and be highly skilled in laparoscopy and because most aren't, it's sad to say, I am hearing all these rumors about LAP being inferior. BALONEY!!! Either the doctors are saying it themselves or their staff are saying it to promote their open procedure to anyone considering the LAP which it seems obvious that they don't do. I am having the LAP RNY done on Nov 30 with Dr. Champion in Atlanta who can do the LAP on people up to 450 lbs. and even then if you are larger than that he does a procedure called the half-LAP. There is no reason to choose an open if the LAP is available to you. Best wishes on making an truly "informed" decision.
   — Toni K.

November 27, 1999
Best to ask your surgeon about this. Some surgeons make sure to do the Lap procedure exactly the same as the open procedure, except of course for the method of entry. Other surgeons may "modify" the standard RnY to make it easier to do lap. That's not necessarily a good thing for you in the long run, so be sure to ask.
   — Lynn K.

November 27, 1999
I would suggest also that the best person to answer your question is YOUR doctor. The reason I chose open RNY is because it is endorsed by the National Institutes of Health, unlike Lap because according to them they don't have enough information on that particular procedure yet. I would advise you to make sure that your surgeon is very experienced in whatever procedure he uses, and that he has done many surgeries and has a good track record. I have read that many more lap procedures have complications due to the fact that it is hard to see even with the laparascope, when there is so much tissue to deal with. That is probably why in some of Dr. Champion's cases, he may have to modify his technique, and do a partial open/lap. Whether this is actually the case is something I don't know because I am not a doctor. Again, I urge you to ask your doctor, and get a second or even third opinion.
   — Patrice E.

November 27, 1999
P.S. The Drs. Wittgrove and Clarke at the Alvarado Medical Center in San Diego, CA pioneered the LAP RNY and have been doing it for about 10 years as well as performing the open. They keep detailed statistics of their former patients and know about the success of the Lap Rny more than most due to their detailed tracking methods. The singer Carnie Wilson recently had her Lap Rny done there. They have a VERY detailed website of RNY information at http://www.gastricbypass.com
   — Toni K.

November 27, 1999
According to the Alvarado site: "We have recreated the Gastric Bypass, Roux en-Y as an advanced laparoscopic procedure, using the same anatomy and connections, and varying only the instruments used to perform it laparoscopically. The results of this operation, which we have published and presented internationally, show: Operating time is slightly longer than the open operation (about 90 -120 minutes laparoscopically, versus 60 - 90 minutes open). Recovery time is shorter: typically 2 days in the hospital, and 10 -14 days to return to full activity. Weight loss is excellent, averaging 80% of excess body weight after one year, and maintained at 80% for four years following surgery (for as long as the operation has been done this way). Over 95% of all weight-related health problems (co-morbidities), such as high blood pressure, diabetes, sleep apnea, gastroesophageal reflux, stress incontinence, and degenerative arthritis pain, are relieved by one year after the operation - often much sooner. Mortality rate has been less than 0.3%. Complication rate has been similar to that with the open operation, except that no incisional hernias (hernias occurring through the scar of the incision) have occurred, with the laparoscopic technique. We emphasize that one should not think of the laparoscopic operation as reducing the risks of bariatric surgery. It reduces pain and discomfort, inconvenience, recovery time, and scarring. Cosmetic results have been an added benefit for some of our younger patients, who now are proud to wear a two-piece bathing suit. Laparoscopic Gastric Bypass can be performed on all but the very severely obese (over 380 lb). We advise against attempting the technique when patients have had prior open operations in the upper abdomen, especially on the stomach." Make sure that whoever does your LAP has years of experience behind them like the doctors at Alvarado or Dr. Champion. I was informed that Dr. Champion to a year sabbatical just to learn how to perform the LAP by RNY and he has been doing it for years and it has an excellent reputation. I checked with the AMA who confirmed this. So whoever you decide on, do your homework, talk with former patients and perrs who had the LAP and then make your own decision. Best wishes again!!!!
   — Toni K.

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