Need help with Open -vs.- Lap RNY

Greetings all! I have a surgery date for 04/10.  What I am a little worried about os the possibility of having to have open RNY.  I have been told that they won't know until I am on the table and that I should do everything that I can in the mean time to get my weight down as well as shrink my liver. So... I've been looking at as many pictures of men that are the same size or bigger than me and from what I can tell, they have been able to have Lap.  Is there a certain BMI number to use as a guideline?

Hey .Robb My buddy Paul is right....again.... I click on your surgeon, when he last updated his profile, he had done 300+ lap rny, and only 5 that had to be open....I bet his numbers are even better now but the fear of an open RNY, is a sure fire thing to get to you stick to your pre-op diet... but I don;t think you wanna tell him if he can't see, to back on out, and send you home.... hey dude, we have a spot warmed up for you on the loosers bench, I hope someone dosen't get this premo spot.... now get your AZZ on the loosing side Russ

I went to 2 surgeons preop, and both had rules abotu size and doing an Lap procedure.  The first had 400 lbs as his cut off.  If i was over 400 lbs (and i was) i would have had to get an open procedure.  The 2nd sugeon would have done a Lap procedure on me at almost 500 lbs, he's actually done bigger people lap, but because I wanted the DS, he would only do it open.  The DS is a longer operation, and it would have been too dangerous to keep me under that long.  Instead of having a 2 part DS lap, I had a 1 part DS open.   It's not that bad, the scar kind of sucks, but then again being 500 lbs really sucked.   Scott

Hi Robb, I had Lap RNY on 3/14, and my surgeon told me ahead of time that once he got started, he might have to do an open incision.  At my consultation with him 3 weeks prior to surgery, he told me that I could increase my chances of having a Lap procedure by going on a 1,000 calorie per day, high protein diet.   So, that's what I did for the 3 weeks prior to surgery - he had me on 3 protein shakes (slim fast, high protein variet), and 2 healthy choice entrees per day.    At the time of my consult, I weighed 547, and my BMI was 60.  I'm a very tall guy (six nine), but I was still a very high risk patient.  As he was examining me, he pressed into my ribs - and to my surprise, he found them.   He made the comment that he thought he'd be able to do it Lap if I stuck to the pre-op diet to shrink my liver.   He stated that if there is over 4 inches of fat on top of the ribcage, that usually indicates that he would have to do an open incision. Anyway - that was my experience.   I stuck to that damn pre-op diet to the letter, and he told me afterwards that he was surprised at how small my liver was - so, the diet apparently worked.   My surgeon is also very experienced - he has close to 6,000 RNY's under his belt, and has been doing bariatric surgery for over 20 years.   I've had zero complications post-op, and I'm very glad I found a surgeon as experienced as him.   I'm sure that having such an experienced surgeon also made a difference in him being able to do it laproscopically. Best of luck to you - I hope everything goes very smoothly with your surgery. Chuck