PLEASE stop telling people that open surgery is only for rare, special cases!

debbie0321
on 6/18/12 9:52 am - Cincinnati, OH
RNY on 08/06/12
I had a consult last year with a surgeon that only did open procedures. He claimed that the risk for a hernia went up with an open procedure. That way he could give his patients a TT a year later and it be covered by insurance. I chose not to have the surgery then. The surgeon I'm going to use now does the robotic lap. procedure. You actually get to go home the next day. I'm not sure if he'll be able to do that type of procedure on me since I've had several abdominal surgeries already. We'll see. I'm hoping for surgery in August.
LiciaLou
on 6/18/12 9:56 am - Central, FL
RNY on 08/29/12
Thank you so much Lora. I just had my consult & I knew going in that my surgeon does the open rny. He is the only surgeon in my area that accepts my particular insurance; so it was him or nothing. He is very well respected in my area though & a great surgeon.

From what I had read on here I was beginning to get scared since he has every intention of doing the operation open. I talked to him about this and he said that it has been his experience that it is very difficult to get the pouch as small as he likes during lap procedures. He will be giving me a 20 cc pouch. He said he has noticed other surgeons having the same problem while he has done revisions of their patients. So he said he made the decision that he would rather do the surgery to the best of his ability to keep the patient from possibly needing another surgery later on. I'm comfortable with that; but I was starting to feel like maybe I shouldn't be. I'm glad to know that it isn't the sign of a lower quality surgeon.

Alicia ~ HW 307 ~ SW 287 ~ GW 135 ~ CW 160

Cicerogirl, The PhD
Version

on 6/18/12 11:52 am - OH
Thanks for responding to thsi because it is people like you that I was concerned about being unnecessairly frightened by people talking about how rare open surgery is these day or how no one should submit to open surgery.  No, it is not a reflection of the quality of the surgeon. Even if the reason the surgeon prefers open is that (s)he is better at open, I would certainly want the surgeon to do whatever (s)he was most skilled at doing!  A friends of mine had open surgery and when she asked the surgeon why he did not do lap surgery, he told he was just a couple of years from retirement and just wasn't interested in learning to do it at his age.  He is, however, a highly respected surgeon just outside of Chicago.

I knew that my surgery would be open from the very beginning (and that if I used another surgeon in town (who is the "top" surgeon in town) he would likely at least attempt do it laparoscopically), but because of my high BMI (57) and a potential (but unlikely) medical issue that might cuase a lap surgery to have to be open anyway, my surgeon wanted to do it open.  Yes, lap would have been easier on me, but my primary concern with such a serious surgery was after and having it done RIGHT the first time.

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

Jennifer M.
on 6/18/12 11:37 am - MN
RNY on 02/17/12
I opted for an open hysterectomy because the chances that I would have a successful laprascopic procedure were fairly low.

I think the best way to explain it is that most people have lap WLS.  If it's a planned open surgery with a surgeon who fully explains the procedure, then that's informed consent.  If the surgeon plans to have an lap surgery, but has to convert to an open surgery, and it's fully explained to the patient, then that's informed consent.

The surgeons I consulted, all explained that they would plan to do a lap, but would convert to an open surgery if necessary, but that it was fairly uncommon for them to have to make that conversion.  
    
(deactivated member)
on 6/19/12 12:40 am - WA

I had my choice of a open or lap RNY. My doctor gave me very good reasons to do both types. I chose to go open because I wanted him to see everything clearly and have less risk of nicking. And like the previous poster He told me he could make my pouch small with a lap but even smaller with an open. My doctor is an excellent doctor and at them time of my surgery he had a stellar record. He also was a teaching doctor with about 5 students following him around to learn his methods, My open was wonderful. Yes the pain of the incison sucked and my recovery time was longer but my scar is straight, soft and faded nicely. And I have had zero complications. So open for me was the right choice and it was MY choice.

Jenni_9yrspostop
on 6/19/12 6:46 am
Thanks for clearning that up. My surgeon only does open for a lot of reasons. It works well for some patients, recovery time is the same as lap, we have about a 4 1/2 " incision that is held
together with tagaderm tape-no staples or stitches. Our scars heal up beautifully - no railroad
track like scars for us. He can look around and check things out while he's in there - the health of your gallbladder, liver, etc is important to see visually. When I had mine, lap equiptment knicked many patients causing infections and was looked down on, and if you want something else done at the time of the procedure: tubes tied, hernia fixed-open is the way to go. Besides not having the horrible gas pains that the lap procedure produces is a plus. I had my surgery over 10 yrs ago and would do it open again in a heartbeat. Many are scared of open but with no drains and no tubes, it was perfect for me.
Jen 10+ yrs post op OPEN RNY
×