Question:
Do most people who have open surgery develop hernias?

I am considering self pay because my insurer will not approve (policy exclusions). My research indicates that I will pay less for open RNY than lap RNY. One nurse (of a Dr who does laps exclusively) cautioned me that if I went with an open procedure I was almost certain to develop a hernia down the road which will required more surgery. I'm wondering what the odds are of getting a hernia? If you've had a hernia, when did it happen and how did it manifest itself? Did it require surgery?    — Brenda G. (posted on December 7, 2002)


December 7, 2002
I had an emergency appendectomy back in 1997 which resulted in about an 8-inch vertical scar on my lower abdomen - which also had to be left open due to the ruptured appendix. My open RNY was in July of this year with another 6-inch vertical scar on my abdomen. I've had no hernias from either operation. I had an abdominal binder for my appy - none for my RNY (nor did I ever feel that I needed one). <p> I believe that nurse who is telling you that you are almost certain to develop a hernia if you have an open RNY is trying to drum up business for her doctor. Because, the great majority of people who have open RNY's DO NOT have hernias if they use common sense while they are still healing...JR
   — John Rushton

December 7, 2002
I agree! I had my Open RNY 11-11-02 and am fine I still use the binder but am weening myself off of it. I was warned that it was a possibility by my surgeon as well as infection of the incision due to my size, but so good so far!!! I don't think that most people get them but it does happen and you should factor it in.
   — dkinson

December 7, 2002
I agree with John. I think your nurse is trying to drum up business. Most do not get hernias. I had open rny 7 months ago & never used a binder and have had no problems. (And I've been very active.) Even if you did develop a hernia, wouldn't that be a separate medical problem and be covered by your insurance anyway? I'd say go for the open procedure and save your money for other things. Good Luck!
   — LisaTaz

December 7, 2002
I had open RNY on Oct 16, 2001. I did develop a hernia. But in my humble opinion.....this is such a bonus!!! It is a small hernia...no pain or anything like that. My insurance is now paying for my tummy tuck. Most insurance companies will pay for a tummy tuck with hernia repair. I could not have paid for a tummy tuck on my own. My tummy tuck is Dec 23rd. Cant wait!!! I have had NO other complications with my open procedure. Good Luck!!
   — skymaxjr

December 7, 2002
Brenda ... I'm 2-1/2 years post-op open VBG, and I've never developed a hernia. I'm with the previous poster who said it sounds like the nurse you spoke with is trying to drum up business ... or scare you away from taking your business elsewhere. I'm not even sure you could estimate the risk of developing a hernia -- but you might want to ask your surgeon what percentage of his/her patients eventually develop one, and what, if any, common factors would have linked the ones who did. Informed is best, so ask, ask, ASK! Warm skinny thoughts,
   — Cheryl Denomy

December 7, 2002
I had an open RNY 8 months ago, I had heard that hernias were very common when you have an open procedure so I was VERY careful because I certainly didn't want anymore surgery....well, I got one anyway, I can't imagine what I done to cause it but it is huge!
   — Brenda V.

December 7, 2002
I also developed a hernia after surgery of an open RNY in july of 2001. It was painless but it caused a large lump on my incision about the size of a grapefruit. Hernias are much more common with open RNYs than with the laps. Like another poster stated this helped me get my TT approved(Nov 12) by having a hernia. I was very careful after having my surgery so it wasn't neglect on my part. It just happens to some people and not others. This was my 4th abdominal surgery and my second hernia one of which I didn't know anything about till my DR did the RNY. I would have the surgery open and just do as your DR states and the odds are against you getting a hernia. Good Luck
   — samizaki

December 7, 2002
I have seen figures indicating that something like 25-30 percent of open RNY patients develop hernias (so it isn't "almost certain"). As a patient, you can be super-careful and still develop a hernia even months after surgery and not even know how or what you did (if anything) to cause it. So with open, it's just part of the odds you have to live with in having the surgery. But in your case, if you were one of the unlucky ones to get a hernia down the road, I wonder if your insurance would pay for hernia repair later on even if didn't pay for WLS. I'd suggest you check on that question, as well as who pays if there are any complications with the RNY surgery (heaven forfend!!). I have the impression that some policies will pay for surgeries incidental to a surgerical procedure the policy didn't cover, and some won't, but I just don't know. Regarding open versus lap, I think the most important thing is to find a doctor with a lot of experience in whichever bariatric surgery he does (open or lap) and who has a good aftercare program. Good luck!
   — Suzy C.

December 7, 2002
Hernia rate or opens is 30%. LAP near zero. You say open is cheaper than LAP. Where did you get the basis for that? Laps actual surgery costs more because of the equiptement but the big reason insurance approves LAP is the shorter cheaper hospital stays. 2 days on average for Lap. about twice that for opens. Hospital days are expensive. When considering self pay what if you have complications? These could bankrupt you. Might consider getting a part time job at home depot for insurance coverage.
   — bob-haller

December 7, 2002
BTW all hernias eventually require surgery. They are a risk of strangulating if not fixed they tend to grow larger. Some folks suffer with hernia belts and such for years.. Reakly uncomfy. Some unfortunates get multiple hernias and need multiple surgeries. They are more likely early on but can occur years later.
   — bob-haller

December 7, 2002
I too have decided to go self pay because of am insurance exclusion. I also found that the open is about $1000 less expensive than the LAP, but was worried about the hernias. I discussed this with my Doc and he said that hernias do occur more often in open, however bowel blockage occurs more often with the LAP, so the two pretty much even each other out. I am scheduled for an open RNY Dec. 16 :-) Good luck to you!
   — Suzanne M.

December 7, 2002
Well the hernia rate on opens is about 30%, blockage is rare around 1 to 2%, although its more serious. ME? I would spend the extra $1000 because recovery is faster, shorter hospital stay and faster recovery decrease chance of blood clots.<P> The big thing isa to get surgery, LAP or open the RNY s the same and can save your life!
   — bob-haller

December 7, 2002
One thing to keep in mind is that even if a lap RNY is scheduled, the surgeon may have to convert to an open RNY sometime during the procedure if there are problems. One of the women in our support group had that happen to her (her GB wasn't were it was supposed to be and the surgeon opened her up just to be on the safe side). <p> Bob - I'd like to see your source for the statement that 30% of open RNY's get hernias. I'm not necessarily disputing it, just like to read the study those figures came from...JR
   — John Rushton

December 8, 2002
I feel like you are talking about me! I had surgery on 11/29/01, which was scheduled for lap, well, things didn't go as planned (organs weren't were they were supposed to be) so he had to open me up. Exactly 1 year later I had my gall bladder removed (due to stones) while the Surgeon was in there he found I have a hernia from the RNY last year. Unfortunately he wasn't able to fix that during the gall bladder removal (infection risks are too high) so I have to go through yet another surgery! Like others have said, I am hoping this hernia will help with insurance approval for a tummy tuck. As the others have said, I hope either way you are able to have surgery, as it was the best thing I could have ever done for myself.
   — Chloe S.

December 8, 2002
John the 30% hernia rate is from my surgeon Dr Philip Schauer. I am suree he has stated that on the online support group meetings that are archived like a movie.<P> http://www.upmc.edu/obesitysurgery/monthlySupportGroup.htm
   — bob-haller

December 8, 2002
I was told the same percentage by my surgeon. About 30% opens dev. a hernia. Laps are near zero. I don't know where the figures come from, but have heard the same thing several times on this Q&A board also. My surgeon always warns his patients that if things don't go as planned during the lap, that it will result in an open. So far this has not happened. I loved my lap. The most pain that I experienced was a 'I've done too many sit-ups-soreness'. I felt great! Good luck in whatever you decide. Its the end result that is important.
   — Cheri M.




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