Open revision surgery vs laprascopic revision surgery

I had my stomach stapled 21 years ago.  I was recently hospitalized with severe abdominal pain and was told that the staple line has failed and I need revision surgery.  The surgeon believes that he can do the revison with laprascopic surgery.  He has to undo the original surgery and then do the modern surgery.   Was anyone else told it could be done laprascopic but ended up with open surgery?    What are the chances of that happening and what is the difference in recovery time?

Thanks for your comments ...  Susan

Hi Susan and welcome!

You might want to post this again under 'Staple line failure' or something - I know there is a lady who suffered from the same thing who might post some information for you.

I get the impression that lap or open depends on the technical nature of the surgery - sometimes they need more space to root round your insides, and sometimes down to surgeon preference - my surgeon only does lap because he dismisses open as 'primitive'!

Your surgeon's office might be able to reassure you about which is more likely, but to be honest the people who have had open DS revision don't report taking longer to get over it than the lap people, so it might not make much difference to you anyway!

Sal

Hi Sal,

Thank you for taking the time to respond to my post.  I am trying to learn how to get around on this site.  How do I get to the post that you told me about?

Susan

My first surgery (VBG) was open in 2003.  I was revised on the 6th of April to RNY and my surgeon said in his hands it would be impossible to do lap beause with all my scar tissue and the take down of my old pouch.  Plus he removed the entire stomach after creating the new pouch.  Even though I'm cut open from my sternum to bellybutton I'm glad I had mine done open so that the dr. could see everything.  I'll probaly go back to work after 4 weeks - I'm a desk job, but very high stress in a newspaper so it might be just half days. 

Hope this helps.

Rebecca

Thank you for responding to my post.  I find it hard to believe that they will be able to do my surgery lapro.  I have had so many surgeries on my belly.  I've had my uterus out, then two seperate surgeries for my ovaries. First the left one out then the right one.  In January this year I had gallbladder removed.  Plus I have had two c-sections.  I know there is alot of scar tissue in there.  I'm hoping for lapro but have a feeling that they will have to do open surgery.  I am very scared because I have a bleeding disorder.  It is well controlled if they follow the presurgery protocol set up by my hematologist.  Nonetheless, I am scared.

Thanks agin
Susan

I had stomach stapling back in Feb 1992. My staple line came open. I was told my stomach is small. Yea for me.

I'm having my revision a week from this Monday!!! April 27TH. I have to have open Surgery. Not Lap. Is Lapro a different surgery?

I had 4 C-Sections and 4 other stomach surgery's. I was thinking it was 3 others, but then I remembered another one.. 

I saw 3 different surgeons. Two of them were also Teachers in WLS! So these guys know what they are talking about! They all told me I had to have open.

They said I had the old style of WLS and I have a mesh around my stomach that needs to be removed too. They have to fix a lot. Plus scar tissues and adhesion's from prior surgery's! They also worry about bleeding too.

There is no guarantee I will have a revision... But My surgeon is going to do his best.. He promised me. So that is good enough for me! I have many other issues too. He is a pro, so I trust him. I  don't want open..But I do want what is best for me. And I know open is the best and safest option for me.  Keep in touch with me. I'll let you know how it goes...I believe in Prayers!! Send them my way please! Best wishes to you...Alizka

Thanks Rebecca for your reply.

Susan

Hi Susan and welcome!

I, like you, have had many abdominal surgeries.  7 in all.  My revision was done open and I was glad it was.  My doctor found bowel obstructions, a large hernia numerous adhesions and he also removed some of my scar tissue.  

Whether a surgeon goes lap or open, depends on how comfortable he is with your situation and what he feels he may encounter.  He may start out by going lap and find an adverse condition that may require him to open you up.  Sometimes it's hard to tell, especially when you have had a lot of abdominal surgeries.  

The important thing is that you have/or find a good surgeon who is qualified in this area.  Have faith in him to know what is the best route to go in your situation.

Good Luck to you.  Keep us posted on how you make out.

I too have had 7 abdominal surgeries.  I also have the complication of having an unexplained bleeding disorder.  Preop I have to have a drug called Amicar and I have to receive platlets to make sure that my blood sticks together during and after surgery.   My hematologist sent preop instructions to my surgeon.  I will also have to wear those stockings for up to 10 days after surgery to help prevent blood clots.   My hematologist thinks it would be safer to do open surgery because the surgeon could see more.  However, the surgeon said he intends to do lapro.  That means he has to take apart the old staping and then redo the new WLS.  My last abdominal surgery the doctor said that there were alot of adhesions and that he had difficulty getting around.  I am told that my surgery is a leading expert in lapro surgery, maybe that is why he is so sure that he can do it that way.  I've been in the hospital twice already this year with abdominal pain.  Both times I couldn't eat ANYTHING without vomiting.  I was put on IV therapy and nothing by mouth for four days.  I was told it was to settle things down inside.  However, everytime I ate I had the same problem.  Many tests were done and they said that my old staple line had failed making food get to the lower stomach and also backing up into my esophogus.  I would vomit in my sleep, if I bent over from the waist, or after meals.  It has been miserable.  I am looking forward to having my insides fixed so I can start to feel better again.  I also hope I can lose the 60 of the original 180 pounds that I have regained these past few years.  The doctors also think that I may have some kind of a bowel obstruction and I know that I have a small hiatal hernia.  I really wish that the doctor would do the open procedure so that he could have a better view of my insides.   Ultimately it is going to be his decision.  Wish me luck because I am scared to death.

Susan

 Hey Susan,

I will send a prayer your way.  I do understand your fear.  Surgery is always somewhat of an anxious time and then when you throw other issues that you have on top of it, it only gets expounded on.

I too ended up in the hospital a couple of times prior to my revision with vomiting and severe abdominal pain.  The first time I went in they "thought" it was a bowel obstruction and wanted to perform surgery.  I opted out at that time because I wanted more assurance that it was in fact a bowel obstruction.  At any rate they inserted a NG tube which pulled up all kinds of bile, my intestines deflated and what they think happened was the kink or adhesion let go.  The other reason I did not want to undergo surgery at that time was because their fix for the problem was also part of the cause for the problem (adhesions due to abdominal surgeries).  I had the occurrence two more times after that and I finally got it repaired with my revision.  The doctor did find 2 obstructions, one the hernia was causing and one an adhesion was causing.  I do feel so much better now.

You poor thing, it must be so rough not to able to keep much down!  Hopefully this surgery will do it for you.  Maybe as a side benefit you will loose the extra weight you are hoping for.  I would suggest talking about this issue with your surgeon before he operates to see if maybe while he is in there cleaning you up he can also revise you to ensure you loose the additional weight you want.  Maybe he could make your pouch a bit smaller or give you more malabsorption if you do not currently have a lot bypassed.  I think there are options and it would be best to pursue it at the same time you are undergoing this procedure.

Good Luck.  Again, I will send a prayer your way.