Lap RNY harder to perform on Males?
??
My doc told me there is a higher chance of being converted to an open than a female would have...
Is this a muscle issue? Or is it because we hold more of our weight in the stomach area?
He didn't give a reason but I was just wondering as I can't find much googling it!
Thank you for your time!
My doc told me there is a higher chance of being converted to an open than a female would have...
Is this a muscle issue? Or is it because we hold more of our weight in the stomach area?
He didn't give a reason but I was just wondering as I can't find much googling it!
Thank you for your time!
~ Your goals, minus your doubts, equal your reality. 
I believe...but don't quote me on this one, the larger the person the more difficult it is to work around the liver. Hearing my surgeon and his partner at the support group meetings, one of the reasons they want you to lose alittle weight before surgery is easier access (lap RNY) in and around the liver. I know they work near it because during my lap RNY my surgeon saw a small growth and removed it. It was nothing (no cancer), but it is good to have a WLS surgeon who does general surgery and can spot things like that and take care of it. Most WLS surgeons have years of general surgery under their belts...Good to have when they are roaming around there. Brian PS One last strange thing...When you sign your waver, you'll be signing something that says if they go in planning for a RNY, but are unable to do it, they may do something else that should be effective in weighloss (example VSG)...depending on what your "guts" look like when they go in. It happens in maybe 1 in 500 or so (I'm guessing) but it could happen...Surprise surprise!!
I have never heard that in all of my meetings, research, etc... but what is the issue and why we need to lose 5% of our weight before surgery is to shrink the liver because it sits right smack dab in the way of your stomach. So when they are doing the surgery laparascopically they put air into your abdominal cavity and need to have the liver shrunk enough to move it out the way to successfully perform the surgery.
On a side note, I would question your surgeon as to why he would make that comment and also ask him how many of these surgeries he/she has done via LAP. If it is a small number then you may want to look for another surgeon. My surgeon warned me that they would convert to Open RNY only if there was a medical emergency such as nicking your spleen or doing something that caused bleeding which they couldn't find or control. Again, only under emergency situations.
So my ultimate advice (if you are satisfied with your surgeon's experience, etc..) is to just lose that 5% of your weight before surgery and your LAP RNY should go through with smooth sailing.
On a side note, I would question your surgeon as to why he would make that comment and also ask him how many of these surgeries he/she has done via LAP. If it is a small number then you may want to look for another surgeon. My surgeon warned me that they would convert to Open RNY only if there was a medical emergency such as nicking your spleen or doing something that caused bleeding which they couldn't find or control. Again, only under emergency situations.
So my ultimate advice (if you are satisfied with your surgeon's experience, etc..) is to just lose that 5% of your weight before surgery and your LAP RNY should go through with smooth sailing.
9/9/09: Highest Weight: 506.5 lbs 9/20/10: Tufts Start Weight: 492.4 lbs
2/7/11: Surgery Wt: 462.5 lbs. 9/16/12: Current Weight: 287.8 lbs.
4/15/12: First 5K - BAA 5K - PR 35:49
Haven't heard of it either but could see some validity in it. Men tend to be bigger than women so it could potentially be more difficult. I know we have a number of gus on this board that started out heavier and had Lap. I know the dude in England they did a discovery show about was like close to 800lbs and he had a lap procedure.
If he doesn't think he can do a Lap on you I would probably look for a different surgeon as open takes longer to recover.
So what can you do to make it easier for a Lap? Follow your doctors pre-op plan to the letter while the preop diet may give you some additional weight loss the real reason is to shrink your liver and give them more room to work. Get moving! start some form of exercise and drop as much weight as you can going into surgery. Again this will make the surgery easier, but it will also make the recovery easier and the overall procedure less risky.
Good Luck.
If he doesn't think he can do a Lap on you I would probably look for a different surgeon as open takes longer to recover.
So what can you do to make it easier for a Lap? Follow your doctors pre-op plan to the letter while the preop diet may give you some additional weight loss the real reason is to shrink your liver and give them more room to work. Get moving! start some form of exercise and drop as much weight as you can going into surgery. Again this will make the surgery easier, but it will also make the recovery easier and the overall procedure less risky.
Good Luck.
Paul C.
First 5K 9/27/20 46:32 - 11 weeks post op (PR 28:55 8/15/11)
First 10K 7/04/2011 1:03 First 15K 9/18/2011 1:37
First Half Marathon 10/02/2011 2:27:44 (PR 2:24:35)
First Half Ironman 9/30/12 7:32:04
First 5K 9/27/20 46:32 - 11 weeks post op (PR 28:55 8/15/11)
First 10K 7/04/2011 1:03 First 15K 9/18/2011 1:37
First Half Marathon 10/02/2011 2:27:44 (PR 2:24:35)
First Half Ironman 9/30/12 7:32:04
Thanks boys - Appreciate the time and effort to help me out here!
I have lost 26 pounds in 11 days of liquid surgery - I have not had any problems at all with the liquid diet!
He has done thousands of these and was pretty sure we could stay LAP, but wanted me to know it was more difficult to do on men.
Again thank you for all of the answers!
I have lost 26 pounds in 11 days of liquid surgery - I have not had any problems at all with the liquid diet!
He has done thousands of these and was pretty sure we could stay LAP, but wanted me to know it was more difficult to do on men.
Again thank you for all of the answers!
~ Your goals, minus your doubts, equal your reality.
OneFinger
on 6/24/11 2:56 am
on 6/24/11 2:56 am
Totally agree with the others that it's probably more an issue of males being larger than females. But glad the doc is telling you the straight story so you can make an informed decision.
Now, based on the experience with my doc / clinic, they do about 5-7 LAP RNY surgeries per week. I have yet to meet anyone at the support group that had to do it open. I think your doc is covering his bases in case something is unusual once they start the LAP.
My docs also stressed the importanct of getting some weight off prior to surgery. Looks like you're doing a great job. Doubt you'll have any issues and the results are fantastic.
Best of luck.
Now, based on the experience with my doc / clinic, they do about 5-7 LAP RNY surgeries per week. I have yet to meet anyone at the support group that had to do it open. I think your doc is covering his bases in case something is unusual once they start the LAP.
My docs also stressed the importanct of getting some weight off prior to surgery. Looks like you're doing a great job. Doubt you'll have any issues and the results are fantastic.
Best of luck.
High Weight = 310 Surgery Weight = 300 Dr's Goal = 200 My Goal = 190 
During one of my pre-op meetings with my surgeon, he remarked that -- in his experience -- he finds it generally easier to operate laproscopically on females because of their anatomy. Lacking the space for female reproductive organs, men are narrower and have beefier ribs, making it a little more difficult to work.
I didn't get the impression it was a big deal, just a little bit of a difference in technique.
I didn't get the impression it was a big deal, just a little bit of a difference in technique.
Apples and Pears
My Surgeon had mentioned that as large men we tend to be more of an Apple shape, whereas women are more Pear shaped.
To be honest I cannot remember the exact reasoning as to why this makes men more difficult to operate on other than he said our shape just makes it more difficult to get to things, when performing the surgery. Sometimes they just have to re-route where they place the intestines when they reconnect to the pouch, which is exactly what happened to me but hasn't caused any issues (knock on wood).
The other guys were spot on with the Liver though... losing as much weight before surgery makes the liver smaller, thus easier to get to your other organs.
My Surgeon had mentioned that as large men we tend to be more of an Apple shape, whereas women are more Pear shaped.
To be honest I cannot remember the exact reasoning as to why this makes men more difficult to operate on other than he said our shape just makes it more difficult to get to things, when performing the surgery. Sometimes they just have to re-route where they place the intestines when they reconnect to the pouch, which is exactly what happened to me but hasn't caused any issues (knock on wood).
The other guys were spot on with the Liver though... losing as much weight before surgery makes the liver smaller, thus easier to get to your other organs.
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