Question:
What is the BMI cutoff for doing Lap vs. Open . . . or is there one?

May 2003 I first visited with my surgeon. He said definiately open because of my weight. Since then, I've lost 30 lbs. Is there a certain cutoff when doctors will do Lap and need to go to open if your BMI is above a certain number??? Thanks for your help!!!!!!!!    — Marie_B. (posted on January 21, 2004)

January 21, 2004
It depends on the individual surgeon his skills and tools. LAP tools for super morbids is expensive. My surgeon did my wife LAP, her bmi was near 60 at the time of surgery. I hope you can get yours lap and I applaude your weight loss!
   — bob-haller

January 21, 2004
It depends upon the skill of your surgeon and the facility in which he's operating. When I had my LAP RNY, my BMI was 61 and he had no problems, but my surgeon was very, very skilled at LAP procedures and he did not specify a limit. Also, the higher the BMI, the more likelihood, special instruments would be needed. Best to ask the surgeon you've chosen.
   — Cathy S.

January 21, 2004
I think it depends on the skills of the doctor. I am a 40 bmi but because I had reflux surgery several years ago, my doctor needs to go in open so he will be able to reverse what was previously done and do what needs to be done now. Talk to your doctor--he will be the best way to reassure you. Good luck. Julie
   — Julie M.

January 21, 2004
I agree with Bob - it depends on the skills and tools available to your surgeon. My son's weight was 442 at the time of surgery, and his BMI was 61, I believe! His Lap surgery went very well, no complications, and very successful to date. His surgeon was Dr. Schauer of UPMC. He has lost over 150 pounds since May.
   — Carlita

January 21, 2004
I can echo the others - my surgeon's heaviest patient done laparoscopically was 525 lbs. He prefers to do lap instead of open.
   — koogy

January 22, 2004
My Doc said that she did a LAP-RNY on someone with a BMI of 70 over the summer. It was succesful and they had no complications but in the future she is limiting her LAP surgery to a BMI of 60.
   — M B.

January 22, 2004
I had open, but when I asked the surgeon about LAP he said I was not a good candidate due to the excess weight that I carried in my upper belly area. He felt it was safer to do open for me.
   — Dragonfly2B2

January 22, 2004
This depends largely on the experience and expertise of the surgeon. Our surgeon is a board-certified bariatric surgeon specializing in laparascopic WLS. He routinely performs lap WLS on super-morbidly obese individuals weighing 500 lbs. or more. Our daughter's BMI was 70 at the time of her lap RNY and she had a completely uneventful surgery...two day hospitalization and back to work full-time in 14 days. As Bob mentioned, laparascopic surgery on extremely obese patients requires longer instruments and in many cases, hospitals require the surgeons to purchase their own specialized equipment, causing many surgeons to decline laparascopic WLS on patients requiring the use of those instruments. If lap WLS is something that you are interested in, then invest some time in researching board-certified bariatric surgeons who specialize in laparascopy. Best wishes!
   — Diana T.

January 22, 2004
My surgeon has a few requirements...the first being that the liver isn't so fatty that he can't see and that the person have no higher BMI than 50 and that the abdomial section of the body wasn't so huge that his equipment would get stuck or not work properly. Weightloss can thin out the liver a great deal. It really depends on your surgeon.
   — Renee B.

January 24, 2004
I think every surgeon has his or her own guidelines. My particular surgeon has a 350lb cut-off. If the patient is over 350lbs, they MUST have open. I weighed 362lbs the day of my consult and asked my surgeon if I lost the "extra" 12lbs, could I have lap?! After examining me, she said I was "thicker" through the middle and for me she would want to do open anyway. Unless there is a reason you just feel you HAVE to have lap vs open, I'd feel better about going with whatever your particular surgeon recommends for you as an individual. He or she is the expert!! God bless & best wishes!!
   — Amy G.

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