Question:
I was denied for lap surgery because of previous abdominal surgery

Iwas denied lap surgery because years ago when my many attempts to loss weight I had a tummy tuck. I made a appointment with another lap doctor in aug., but they well not answer my question until I get there. I hate to wait only to find out that I am being being denied again. I have another doctor that I can get appointment right away, but he well only do open. Some advice on what to do. I really don't want to have a big scare, but are my chances very slim because of all the scare tissue.If I end up with a open are there differnt surgery types that leave different scares. I quess once in my life I got to wear a bikni for a short time,and really like to see that dream again. Been overweight most of my life.Please help I can't make up my mind. If anyone had a lap that had previous abdominal surgery could you recommend someone around western pa that you don't have to wait a year for appointment.    — christine H. (posted on April 12, 2002)


April 12, 2002
Well I just had open 6 weeks ago. Didn't even look into lap because most surgeons wont do laps with bmi over 50 (mine was 63). Also I have heard that most wont do it lap either if you have had any major abdominal surgery because of scar tissue and possible adhesions. It is just too risky trying to do it around all that scar tissue through a small incision. To tell you the truth, the open wasn't as painful as I thought it would be and my personal opinion, from people in our support group and others that I have known, is that those who have open have a lot less problems in the long run than those who have laps. A lot of Dr's do laps by only stapling the stomach instead of transecting (cutting in two). This puts you at risk of a staple disruption, and having to get a revision. If you loose a lot of weight, you will probably need another tummy tuck anyway, and quite often they will take most, if not all of the scar out anyway.
   — Dell H.

April 12, 2002
I had two previous abdominal surgeries, one was emergency surgery to fix a bowel obstruction caused by adhesions. My surgeon was able to do mine laproacopically, however, he did say that he might have to convert to open if anything was wrong. My surgeon has years of LAP experience, and also experience dealing with patients who were too high risk for other surgeons. So, my long answer is to tell you it can be done, however you need a VERY experienced surgeon who has done man, many LAP procedures. OH, and BTW, my surgeon DOES transect! He has been very successful. Unfortunately, he is in Chicago, but I'm certain you can find one in western PA if you look. Best of luck to you.
   — Maria H.

April 12, 2002
If possible, obtain some additional opinions from surgeons with extensive laparascopic experience. My BMI was 47.4 at the time of my lap RNY, but my daughter's BMI was 69 and there was no problem at all with her lap RNY. I had had 2 C-sections and an abdominal hysterectomy (all vertical incisions) and a traditional gall bladder surgery with a long diagonal incision just under my rib cage. I had an extremely successful lap RNY with an operating time of 1 hr 10 minutes, during which the surgeon removed significant adhesions that had formed following the other surgeries. He also routinely transects the stomach as opposed to stapling. Everything is dependent on the experience and expertise of the surgeon involved. Good luck!
   — Diana T.




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