Question:
What is the difference between open and lap RNY as far as recovery, risks, etctera?
I am wondering why have open and have the big scar, when you can have a lap and why do some doctors not like to do laps? — Dawn H. (posted on August 2, 2001)
August 2, 2001
There are those that will tell you that they prefer Open because the Doctor
can "see" what they are doing. Open is supposedly also a shorter
operation because of that (no need to blow the patient up with gas etc).
The longer you are under anesthesia, the greater the potential for
problems. With the Open, the recovery time is 2-3 times longer than with
the Lap. Some Dr's do open because they don't know how to perform the
surgery lap. Also because it is a lot cheaper to perform the surgery lap
(which is also why many people's insurance may only pay for hospitals
performing open). Lastly, lap surgeons actually must undergo training to
be able to handle the instruments while looking at a screen (or through
virtual goggles) and it actually does take quite a bit of skill. I opted
for the LAP mainly because I couldn't take off the minimum 6 weeks recovery
time needed for the open. I have since found (through visiting several
Open post ops from my support group) that the issue about pain and recovery
time really is true. I had minor pain/discomfort while in the hospital and
was pain free a lot sooner. However, my surgery took 3 1/2 hours whereas
my Open friends took 45-1 1/2 hours. Also I have six small scars vs. 1
long one. I won't lie and say that I would've liked a long scar -- but I
will say that I would have the surgery whether I had to have it Lap or
Open.
— Kimberly L.
August 2, 2001
I don't know why there is a persistant statement that lap takes much longer
than open. My lap surgery took 1 hour and 15 minutes. I think there are
many variables that affect time. Everything from patients starting weight,
to variation in body structure to experience of the surgeon. My recovery
was quick. I was in hospital 2 1/2 days, off meds after one day home. I
have 3 one inch long scars, and 2 puncture wound size scars. Bottom line
however, the best surgery is the one the surgeon you are seeing performs
best. I am grateful I was able to have lap surgery with a great surgeon,
but I would have had open if it was my only option. I am so happy to have
had this surgery!
— blank first name B.
August 2, 2001
Dawn -- I meant to say it was cheaper to perform the surgery open (excuse
the typo).
Rebecca -- Note the word "supposedly". Good luck in your choice
Dawn!
— Kimberly L.
August 2, 2001
I wouldn't get too caught up in this one -- either way, get the RNY! It
takes just as long to recover internally from either, its just that you'll
feel better quicker and be able to move around quicker from the lap. The
lap surgeon needs MUCH more experience to get it just right than the open
surgeon. However, I'd never get anyone to do either one unless they were
EXTREMELY experienced! Internally, you still need to heal for 8 weeks
before beginning any exercise program other than walking, or for vacuuming
or lifting over 10 pounds due to the risk of hernia. The scars heal, they
shrink in size as your tummy shrinks, and they get lighter and lighter as
time passes. Either scar is worth it. I had open, I was on pain meds for
7 days - then none. that's not bad. My surgeon performed 4 surgeries on
me at once in under 2 hours and I've had no complications whatsoever! I
wish you the best, let the surgeon decide or help you decide based upon his
experience.
— Cindy H.
August 2, 2001
I feel like this is similar to the question regarding having a child
through regular or c-section deliveries! I had 4 c-sections and still
consider all of my deliveries 'regular'. Hopefully we all get the surgery
we need, that our doctor is the most experienced in and our insurance
covers. I see some mentions of different length of time for the actual
surgeries as one possible difference. I have always heard and thought that
the laps took longer, yet one poster said this is not true. I think that
there is also the misconception about recovery lap vs. open. I had open
RNY, was in the hospital for only 36 hours, took pain pills only 2 days
after arriving home, had no drainage nor nasogastric tubes, had no problems
with staples and am doing fine at 6 weeks post-op. Learning as we all do!
Ultimately, I think that you can search for the doc that does the type of
surgery you want, be it RNY, DS, gastric banding, open vs. lap, etc.
Sometimes, it does boil down to geography, doc expertise and insurance
though. Good luck in your choice.
— Molly S.
August 2, 2001
This is covered in Barb Thompsons book. LAP has a easier recovery but the
main advantage is a real low chance of hernia. I% or less with LAP, 30% for
open.
— bob-haller
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