Why Open over Lap?

Thanks Annette. I'll call back and ask about it tomorrow. Im thinking its too late in the day now.

Hi Kim, My surgeon (Dr. carlin) likes to do lap, because he say's lap is safer, there's less bleeding, there's a quicker recovery time, there's less scaring. it's less painful, the chance of infection is reduced, and there's less of a chance of a hernia, just to name a few. God bless you, Annette

**Annette that is exactly what my surgeon said. I had 180+ to lose and mine was lap. **Kim ---- One it depends on the skill of your surgeon. Some feel more comfortable doing lap and others open. Each has their own theory. It also depends on your body. I OOOOOZZZZZZZZZZZZZZED .... imagine how much more bleeding I would have had if it was open. My surgeon does strictly lap unless he has to switch to open. Another surgeon I saw had done many many opens (which is what he wanted to do on me) but only a 10th of his surgeries lap. Discuss both options with your surgeon and ask questions "WHY" about all of it. Sheryl In the Zoo

It really depends on both the surgeon and the patient. Some people are too wide in the middle for the lap instruments and some surgeons simply do not have the experience needed to do it properly. If you do go lap try to get a surgeon who's done hundreds of them as i'm told (and i learned the hard way- an aborted surgery) that you should try to have a surgeon who's done at least 100 of them (my first surgeon had done 75 and my 2nd surgeon had done over 1200 and it made a HUGE difference) Also here in Michigan a lot of people are going with the micropouch and i'm told that has to be done as an open procedure. I wanted lap really badly because the risks were lower and the time to heal was much quicker but for some people it's simply out of the question.

I had lap ... my doctors (and all the doctors in that group in Grand Rapids) do lap unless they find they can't do it ... then they switch to open. They are very experienced in doing the lap procedure and so there are few complications. I was out of the hospital in two days (one woman in my room was out after one day). I had no complications, no hernias, no excessive bleeding. I have six little scars, and you can only see one of them now (and that one got a little infected). I would much prefer to have the lap procedure because the recovery is quicker. But it depends on your situation and your surgeon's expertise. From what I understand, a lot of doctors on the east side of the state don't like to do lap and aren't experienced in it. Over here, they all want to do lap if at all possible. Eileen lap rny 6-29-04 347/204/170

Open vs. Lap? That was a brave debate to get started but so far there havn't been major flames. Ok - 1st - it really is up to the surgeon as other posters have said - for instance your girth, previous history of surgery (ie abdominal) or other things that may impact the need to go Open vs Lap. With the Lap, there is a shorter recovery time but higher incidences of complications. The open is longer recovery time but the surgeon may be able to "see" better. I thought about Lap - but given my previous surgical history - wanted to discuss the pros/cons with my surgeon. Together we came to the decision to do open. Ultimately, they found a hernia they may not have otherwise discovered during my surgery. So - to my way of thinking - it was a good thing because it helped me avoid another surgery later. God forbid. Another patient on my floor this weekend had her lap immediately after my surgery.. She was up and moving much faster than I was and I will admit that I was pretty jealous on Saturday morning of the rapid clip she was taking around the halls. But, complications arose and when I checked out yesterday she was going to be there another day/day & a half. So - here is the part that I think *may* draw flames - the east vs. west side of the state discussion. Eileen stated: From what I understand, a lot of doctors on the east side of the state don't like to do lap and aren't experienced in it. Over here, they all want to do lap if at all possible. I'm on the west side and specifically selected to go to the east side for surgery because the volumes of patients are higher which typically equals better health outcomes. Dr. Kurian - who did Al Roker's Lap/Fobi indicates in her book that while she prefers to do LAP- she would select a highly competant surgeon who was comfortable with open before she went with some less experienced who prefered the LAP. As the saying goes - opinions are like a** holes - everyone has one. So, take or leave mine as you like. I'm off to hunt up some Lortab and become one with a horizontal object! (I mean a couch for those of you with dirty minds. Tsk, tsk.) Best, Michele P.

Hi Kim, My surgeon recommended LAP instead of open for me, which is what I wanted. Recovery time is quicker, less complications, less blood loss, less chance of hernia, no big scar! Of course there's risk with any surgery, but LAP is definately less risky. A lot depends on your surgeon. If my surgeon hadn't done hundreds of LAP procedures, I would have gone with the open procedure (and I'm sure he would have recommended it.) I was very fortunate to have a doc who's tops in his field. I'm 2 weeks out today, no problems, not a lot of pain, and well on the way to recovery. And yes, the Micropouch can only be done with the open procedure; the LAP instruments are too large to create the tiny pouch. Hope that helps! Beth

Hi Kim, I had my surgery on November 29, 2005, I am now 5 weeks out today. I had my surgery done Lap by Dr. Carlin at Henry Ford. Your surgeon will tell you what they think you should have done wether it be Lap or Open. I do know that Dr. Carlin told me that most of the WLS surgeries at Henry Ford are done Lap. I don't know if I have helped or not but good luck. Jennifer V.

I also had Dr. Carlin, and he is a master at Lap. I had it lap and had no complications whatsoever, although there always can be on any procedure. It's truly a personal choice. Rest assured he would not put you in any danger, so if the lap was impossible in the end, the open would be done. When I was at my first meeting with Dr. Carlin and he was explaining the procedure, etc., I never saw anyone so "in love" with what he does. He's passionate about his craft and I think the lap procedure is his forte'. This sold me. He has alot of them under his belt now too. Some say Dr.'s can "see better" with the open procedure, but Dr. Carlin stated he can see much better with the lap cameras, he checks all the areas out "up close and personal", checks for hernias, any other abnormalities that may be in there. So I guess it's just what a Dr. is comfortable with and what you decide to choose. Whatever it may be, best of luck to you!!! Hugs, Theresa

Thanks everyone. I feel better. If all goes well, I will be having the procedure with Dr. Carlin, and from what you tell me, that's a good choice. Thanks for the input!