Lap vs Open DS.

I didn't even ASK my surgeon which he was planning on doing.  Once in a while, I defer to stuff like education, training and experience and decide that the expert ought to do the procedure the way HE feels most comfortable.

After that, when discussions came up, I decided that I was just fine with the open...MOSTLY because it makes the surgery go much faster and the less time I'm essentially dead in the OR, the happeir I am.  Also, the less time I spend in that position, the more likely I am to avoid rhabdomyolysis  ( www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001505/ ) and the less I have to deal with the gawd-awful gas pain I had after the band.

There are some who think that lap surgery heals faster.  I don't think so.  I just think that the incisions heal faster.  And I wasn't all THAT convinced that my tidy little LapBand incision scars were all that attractive.  (I thught I looked like my belly had been bird hunting with Dick Cheney.) But here's my comparison on that issue:

One local college football team has decided to celebrate its GREAT season in your living room.  The OTHER local team has decided to mourn its lousy season in your neighbors living room.  They ALL get drunk and disorderly and smash stuff and spill stuff and leave various types of bodily fluids on your personal possessions and those of your neighbor. 

The only difference it that the kids in your neighbor's house entered and exited by driving through the front door inside a Volkswagon Van and the ones who partied in your house climbed in and out through various open windows.

You know what?  On the inside...of BOTH houses...there's no difference.  Your house may LOOK BETTER, sooner...but you have just as much **** to clean up as your neighbor does.

In fact, I suspect that people who have lap surgery MAY tend to overdo a little too soon because the incisions look healed.


But I'm open to differing opinions.  What do you think?

What a great post, I can't wait to see the responses.  I had my original band open......4 inch scar......and then my 2nd band "lap"......I'm pretty sure Lt. Col Martin will be doing mine "lap" which I thought I was happy about....but reading the post I wrote about "surgery time" I am wondering if "lap" takes longer?  Maybe "open" is better?    Of course I think I am remembering more "muscle" pain with the open......due to a larger cut in the muscle?   hmm.......again GREAT TOPIC!

One of the concerns that many of us have is the "visibility" that the surgeon has with an open vs lap procedure. Maybe this isn't the case with the DS, but I know that most general surgeons now prefer lap and say they have more visibility than with open procedures. I don't really get that, but that's what I hear.

As a revision patient, I would have never even considered lap if it were an option.

Another concern is the scarring. I say that the DS is such a life saving operation that the scarring is the last thing preops should be worrying about. That's besides for the fact that I think my open, revision  incision looks much better than all the lap scars from my initial RNY.

 I recovered from the open DS a lot faster and in less pain then I did with my lapband lap surgery. And I agree that the gas pain was dog awful after the lap, plus I was sooooo sick to my stomach after it.
I had none of those problems after the open surgery, I was out of the hospital 2 days after surgery and 2 days later went shopping with my daughter.
I healed just fine.

This is a great post!

At the time of my surgery, I had already been through a few open abdominal sugeries and to tell you the truth, I didn't care how it was done.  My recovery, I guess, was exceptional from what I read here.

Michele

 Like you - I was willing to defer to my surgeon's comfort level with his choice of surgical technique.   I truly didn't care if I was open or lap.    I know that the infection and bleeding rate of a lap surgery is better than open, and that usually less adhesions occur.    Open surgery also has a greater risk of an incisional hernia, but hey, I might have gotten a tummy tuck out of that, LOL.

I've had both open and lap surgeries, and here's my take on the two:

My open surgery was a bit less immediate post-op pain, but a longer recovery pain-wise.   I was more sore for a longer period of time...perhaps two-three weeks.    It was tough to get in and out of chairs, bed, etc.   I remember that I still had pain in my incisional area, especially when bending, stretching or reaching, for a month or two.   

With my lap DS, my immediate post-op pain (first 48 hours) was worse, but I attribute this more to gas pain from the Co2.    Also, I had more internal incisional points than with my open gall bladder, so I imagine that came in to play as well.   When I first woke up from my surgery, I was in extreme pain, and my first night was pretty heinous.     Truly though, after day three, I was not in a great deal of pain at all.   I moved quite freely, and recovered faster than with the gallbladder surgery.    I was tired for a couple of weeks, but that was it.    

I'm sure results vary with everybody....

Personally, I was just scared to death of big open incisions.  (Which is why I am currently procrastinating scheduling the plastics my hubs is generously offering to pop for.)   Scars themselves did not scare me - nothing could look much worse than the road map of stretch marks I already have.  I was just a wuss.

I've had both types of surgeries.  The open abdominal surgery was 100X worse than the lap DS in terms of pain, healing and length of recovery.  Based upon my personal experience, I would choose a laproscopic procedure over an open one any day!
Lisa

Same here.  Plus the lower incidence of infection,  etc.

My lap surgery knocked the **** out of me and I had a hell of a recovery.  It was truly about what was done INSIDE and not about the little incisions.  Dehydration is an issue no matter which surgery you have. 

I agree with you 100%.

~Becky