Question:
How is surgery type such as open vs lap RNY determined?

What factors into the doctors decision on which to perform on a specific patient?    — LISA O. (posted on April 3, 2002)

April 3, 2002
Our dr. had a 350lb weight limit for having the lap procedure...that and no prevision abdominal surgeries other than gallbladder... I know other drs. have higher weight limits
   — Allie A.

April 3, 2002
Hi! Our doctors do about 85% of their procedures LAP. There are several factors in determining how they decide. If you are apple shaped (thick through the middle) LAP is more difficult but still usually successful. Previous surgeries also are a factor. We have actually done a gentleman who weighed over 500 pounds. However, some laparoscopic instruments are too short to allow LAP surgery for some patients in the super obese category. Also, some patients have a fatty liver which makes it difficult to adequately view the surgical field laparoscopically. (I was in this category - I had to be converted from LAP to Open due to a fatty liver - still no regrets though!) Here's a tip: Losing as few as 20 pounds prior to WLS can reduce the size of your liver significantly making it easier to perform the procedure LAP. Best of luck to you!!
   — ronascott

April 3, 2002
my dr. wont do lap if your bmi is over 50
   — chrissy T.

April 3, 2002
It also depends on the doctor. Some are more comfortable doing lap. Some are more comfortable doing open. If you specifically want one or the other, make sure the doctor you have chosen does the one you want. There can be good reasons for choosing either procedure. I actually don't care one way or another. Whatever the surgeon is most comfortable doing on me will be just fine with me.
   — garw

April 3, 2002
I was 407 lbs. pre-op, and I couldn't find a surgeon who would consider me for lap. Most have a 350 lb. limit or they will do you open.
   — Terissa R.