Question:
Does anyone regret having open RNY instead of LAP?

My DR. talked me into doing Open vs Lap he said that the surgery takes less time so it's less risky. He said Lap patients have to stay in the hospital one extra day because the Lap doesn't lend itself as well as open because of the location of everything. He also said the scar amounts to the same except ones vertical the other is scattered. He's very experienced in both he does 30 rny a month.    — Candace F. (posted on December 23, 2001)


December 23, 2001
I know that this isn\'t really an answer to your question but... I had Lap. I am doing fine. I\'m 11 days\'s out and one of my steri strips just fell off and one of my incisions is a tiny hairline. Already healed. As far as the extra day in the hospital, it sounds like BS to me. I went in at 7:30am, they started at 8:00am, it was a two hour surgery and an hour in recovery. I was in my room by 11:00am. I was walking by 12:30pm. I was released the next day at 12pm. There was no extra day in the hospital. From what I\'ve heard, open patients tend to stay in the hospital a tad bit longer than lap patients. Hope this helps.
   — tmrivas

December 23, 2001
Well, as for me, I voted for Open. I\'m a nurse, and I did not like the idea of a doctor operating on my without visualizing what he is doing...I mean, in front of his eyes. I know they can see what they\'re doing, but it seems sensible to me. He could look at and feel my gall bladder to evaluate it. I opted for Open, as well as my two sisters and we are not sorry. Best wishes.
   — Yvonne R.

December 23, 2001
I had no choice, but I can tell you that my open rny was easier physically than I ever expected. I was in the hospital longer than I wanted to be (7 days), but that was my surgeons orders. I was in ICU 3 days (treated the greatest). Happy to be home I stopped all pain meds 1 week post-op. I consider myself blessed. He took out my apendix and gall bladder, does that take away a few pounds off the scales (just kidding). I have a long scar, but it blends in nice with the stretch marks so who cares, no bikini for me EVER!Good luck with your surgery no matter how your Doctor makes your tool for a new life.
   — Angela S.

December 23, 2001
I had lap gallbladder surgery several years ago. I got a pocket of co2 gas trapped in my shoulder and it hurt a lot for about a week. My back also went out from the amount of time spent on the operating table. I was up and walking the day of the surgery and home the next. I had open wls, went in on mon morning came home Thurs afternoon. While my incision was a 4inch cut down my tummy, I really didn\'t have much pain, and what pain I did have the morphine took care of. Because I was only on the table for a little over an hour, and because I was able to roll on my side the afternoon I had surgery (something not all people can do because of pain or whatever) I didn\'t have back problems. With both surgeries you still have to be careful of lifting things because while the lap may be healed on the outside, leading you to believe you are stronger than you are, the insides still have to heal. Personally I trusted my dr and would have had either one to get the surgery. There are advantages and disadvantages to both. good luck
   — Becky K.

December 23, 2001
Hello, I have not yet had RYN, but I too had my gallbladder out with lap and you DO NOT have to stay in the hospital an extra day. You actually get out sooner. I as pregnant at the time so I was in for 3 day, but had I not been pregnant, I would have been out the next day.
   — Chelsea C.

December 23, 2001
Thanks for the responses. The reason I think they require you to stay an extra day is because they can\'t test for leaks easily in a lap. I\'m sticking with the open. I too had my gallbladder out lap bur they lost stones they couldn\'t see because of it and I ended up jaundiced and in Icu until they could get them out. So it was easy for them to convince me open was better. I was just having second thoughts for a minute.
   — Candace F.

December 23, 2001
I selected LAP because I didnt want another surgery. 30% of opens get a incisional hernia and require a surgery to fix it. The chance of a incisional LAP hernia is near zero. Around here opems hospital stay is longer. Lap 2 days, open 4 days average. My wife is 14 days post op LAP abnd her incisions are almoist totally invisible, just 2 are small red marks.
   — bob-haller

December 24, 2001
I had open simply because my surgeon does not DO lap. I really didn\'t care either way, personally, though I know some definitely prefer lap. My surgeon also told me that lap takes longer - twice as long, in her estimation - and that the quicker they can get an obese patient off the operating table, the better. There is a phenomena that can happen with obese patients... anesthesia gets stored in \"pockets\" in the body, and may not be released until the patient is in recovery and has been given pain meds! IF the patient gets re-anesthetized with pain meds on board - there can be real trouble! They can stop breathing, etc. My surgeon DOES plan to possibly start doing lap surgery in the next year or so - maybe - but ONLY on the healthiest of her patients... and the smallest... and ONLY because there is such patient demand for it. Best of luck to you in your decision! :)
   — [Anonymous]

December 24, 2001
I had open, because I too wanted the surgeon to see what he is doing, and be IN there if something happened. And besides I had the new procedure called \"micropouch\", and the pouch is smaller than the lap instruments, thus making lap impossible. My pouch will never stretch, and never have to be revised. I will never have acid reflux either. I love it, and it had to be done open.
   — Phiddy B.

December 24, 2001
I had lap and there is no way I would have had open. I state that for several reasons; the chance for incisional hernia (as someone mentioned open is 30% risk). I was back to work much quicker. Many with open take 6 weeks off -- there is no way I wanted to be home for six weeks. I was back at work -- and more imporatantly, getting back to all of my usual activities (shopping, movies, hanging out with friends) -- in 10 days. Also, I didn\'t want a big scar with a bunch of staples and a drain at home. I had no stapes, no stitches and my drain was removed before I left the hospital. My scars are so tiny and already fading and I am one month pre-op. Also the story about lap lasting twice as long is typically not true. It only takes longer if the doctor is not adept with the tiny instruments. If you have a dr that works with them all the time the length of surgery is actually quite fast. I was on the table for two and half hours. That is even less than some who have open. My doctor does all kinds of lap surgeries (gall bladder, spleen, appendix) and thus, is very fast. If you are trying to decide between lap and open don\'t just ASSUME it will take longer. Ask the doctor what the average time is for sugery. It varies greatly from doctor to doctor. This is very important as I read and again and again that it is always longer. That simply is NOT true. Frankly I think that lots of doctors tell their patients that open is better simply because they do not perform lap and don\'t not want to lost the business to someone who does. Think about it, what doctor is going to tell you lap is better but I don\'t do it so go to a different doctor. Very unlikely.
   — Kirstin99

December 24, 2001
I think the least invasive procedure, the better. IF you have a surgeon who is proficient in performing the lap procedure, than there is nothing to worry about. Claims that you can \"see better\" with open are unfounded. We just see it that way because we are not surgeons! It\'s whatever the doc is proficient in. And you can magnify images with lap as well. I\'m going lap, but like everyone says they are pluses and minuses to both. Good luck!
   — [Anonymous]

December 24, 2001
My surgeon performs both lap and open surgeries, but I opted for open because he said that it is easier to see and it was less expensive. I don\'t think that is \"unfounded\" according to him that it\'s easier to see. He also stated that in some cases of other surgeons who perform lap, that some people have to be opened up anyway, because of not being able to see. Anyway, patients of my surgeon can go back to work in 2-4 weeks after having open. I had surgery on Dec. 10th and I\'ll be back in college classes on Jan. 7th. I\'m at 2 weeks right now and I\'m feeling great. I never had a feeding or drainage tube and I didn\'t have any staples. My surgeon uses dermabond. It\'s like a human superglue. I don\'t think there will hardly be a scar. It\'s clearing up so nicely. I\'m not in any way putting down lap procedures, however. I do see the benefits of it. I had my gall bladder removed through a lap procedure. Perhaps it\'s just my surgeon, but he did an excellent job with the open procedure.
   — Jaimee S.

December 24, 2001
the choice was left up to me. I chose open , I was unconcerned about the amount of scaring. I was very concerned about the amt of time I would be under the anesthetic , I would spend less time with open. A former boyfriend of mine is the chief of anesthiology at a large university hospital, he told me we should be put under with the least amt of meds for the shortest time possible. For me , at my age and with my medical history, open was the correct choice for me. You must make your own evaluation. I never regretted my decision.
   — Rose A.

December 24, 2001
It seems like \"Anon\" gets around. My surgeon does specifically say that it\'s easier to see open vs. lap. I chose open.
   — Tieia

December 24, 2001
I did not have a choice becuase I had previous abdominal surgery - I had the open surgery and am glad. I wanted the doc to see everything and to be under for as short a period of time as possible. I had no problems whatsoever.
   — Lisa B.

December 25, 2001
I didn\'t have a choice between open vs. lap because my surgeon only does the open procedure. He has studied the lap procedure and does\'t feel comfortable with it. I trust his judgement 100% and am happy with my decision. If you trust your doctor and he recomends open and you don\'t have a problem with the scar I suggest you go with that. I do want to tell you about my experience with lap gallbladder surgery 9 years ago. I had one of the leading surgeons in my city with tons of experiece doing lap gallbladders. I didn\'t have a problem during surgery but 5 days later passed a gallstone that was left behind in one of the ducts. This was a very frightening experience right after surgery (I even called 911 and the paramedics found me curled in a ball on the floor the pain was so bad). If the surgery had been open the doctor would have been able to feel that stone, but couldn\'t visualize it on the x-ray because of the postion of the picture and he couldn\'t see it through the laproscope either. Based on this one experience I prefer open surgery.
   — georgiacarol

December 26, 2001
As with everything in life, the post op courses of open or lap will vary with each individual. Nothing should be given as absolute fact. I had open surgery 1/8/01 and my recovery was extremely uncomplicated and easy. However, there are many lap patients that recover much slower. I was really not given a choice of procedures. I will only occasionally regret my open \"scar\", which is actually fading rapidly. My surgeon uses skin glue and no staples, so my scar is a pencil thin line that only 2 people see! I would love to see the documented proof of the 30% figure for hernias. I am sure the rate is higher for open (obviously), but that percentage seems high to me. Could the increased rate be due to the hanging apron pulling on the incision? Those with the largest aprons would not have been candidates for the lap, so therefore would have to have had open? I think we can use statistics to say whatever we want. But, we need all of the facts. I have had no problems and my surgeon feels that my risk for hernia is now close to 0. However, I answered this question to say what I have noticed to be a \"trend\" with the post ops on this board. This is extremely unscientific and only my personal observation. It seems that those patients that have leaks, surgical complications, or post op complications tend to be lap procedures. Whenever I read about someone with a complication, I click on their profile and the vast majority are lap. I am certain these risks depend on the expertise of the surgeon. This \"opinion\" is given only to encourage thorough research of your surgeon (open as well as lap!). Shelley
   — Shelley.




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