Question:
Can anyone give me info. on which procedure is better-Lap rny or open rny?
I have just been approved for surgery and my M.D. has asked me to choose between open and Lap rny. He seems to prefer open but I really can't decide and I have to tell him by Oct.31,2001. Can anyone help with some comments on how they decided. — Brenda E. (posted on October 27, 2001)
October 27, 2001
Hi, Go with Lap if you can, the incisions are much smaller, and the
recovery time and hospital stay is usually shorter. This isn't always the
case and some with open have quick recovery times also, but in my case, I
had Lap, and was out of the hospital quickly, and out and about in about 3
days after coming home. Best wishes to you.
— Carey N.
October 27, 2001
What's the difference to him? I mean, some docs do transect if they do lap,
but do not if they do open. And some vice versa. Some do more of a bypass
open than lap. The immediate means of surgery will not be as important
tomorrow as the type and style of surgery you get today.
— vitalady
October 27, 2001
I chose laparoscopic surgery because it meant a shorter hospital stay and
quicker healing, and also only 6 tiny incisions instead of one great big
one. However, if it proved that my surgeon felt, while I was on the table,
that he had to do an open, then that would have been okay, too. That was my
choice.
— Marjorie B.
October 27, 2001
My response to this question is always that IF an experienced bariatric
surgeon with expertise in laparascopic surgery is available to you, then
always choose the lap. The key words here are
"experience...bariatric....and expertise". If I had to choose
between a lap surgery with a surgeon without those qualifications and an
open surgery with an exquisite surgeon only qualified to do open surgery,
I would choose the open surgery. A uncomplicated, transected lap RNY
performed by a qualified practitioner should take an equal or shorter
amount of operating time than an open procedure; offers less chance of
infection and wound complications; and gives the patient the opportunity
for much less post-op discomfort and much more rapid recovery time.
Remember, however, that even though the work on the "outside"
seems simple...the work on the "inside" is exactly the same as
with an open surgery. Either procedure is still a major surgery so allow
plenty of time post-op for adequate rest and recovery. I think that it
would be interesting to ask your surgeon why he prefers open, if he offers
both. If his experience with lap surgery is new or limited, that might be
the reason and might influence your decision. Good luck!
— Diana T.
October 27, 2001
I'm having an open rny. At this time, its all my doctor offers. All things
being equal, I would prefer a lap procedure for all of the already stated
reasons. But I can't say that I'm upset over the prospect of having open,
it doesnt really bother me one way or the other. My surgeon said my
incision would be 4" which isn't huge at all. And there will be the
only one cut except for the tube incision. So, to me having my highly
qualified doctor doing what he does best with a minimally invasive
procedure is just fine. Its not the type of procedure as much as the
results OF the procedure that really matters most.
— Donna L.
October 28, 2001
My open incision is just about 5 inches long. My doc only did open RNY and
that's also what my insurance approved, therefore I really had no choice. I
have heard that docs who do the open really think it is important to get
their hands in there and measure, etc. and feel it is important to see it
all. Laps can proceed into open if complications occur. Lap has a different
recovery process I know as I had lap gallbladder removal last year, but
when people state that the hospital stay is shorter or that the recovery is
shorter, I do not agree as we are all different. I was only in the hospital
43 hours as I went into surgery at 6:00 p.m. on a Tues. and left at 1:00
p.m. on Thurs. I went back to work at 3 weeks, etc. I would probably opt
for the surgery for which he had the most experience in your circumstance.
Best Wishes!
— Molly S.
October 28, 2001
My advice is to find a Lap surgeon if you are going the
LAP route. They are more skillful ( generally speaking)
than your garden variety bariatric doctors. But as other posters have said
you may be "opened up" if there are complicatons. Good Luck
— Cindee A.
October 28, 2001
Get LAP if you can because over 30% of opens end up getting hernias, that
ultimately require another surgery to correct. This info from barbara
thompsons great WLS book. The chance of LAP hernias is less than one
percent, so figure this in with a faster recovery, less hospital days, less
pain, smaller scars, and all the other good reasons to get lap. Its mos
important to find a good surgeon.
— bob-haller
October 28, 2001
No one has mentioned that a lap can take from 1-5 hrs, and an open 1-2 hrs.
That's a big difference when it comes to time under anesthesia. Your doc
will consider your co-morbidities and with everything equal, I'd lean
toward the lap, as long as he was confident I could tolerate being under
for so long. Another thing to think about is the bigger you are, the
tougher it is to get out of bed post-op after an open procedure. With a
lap, you're mobile a lot quicker. You've got to get moving asap post-op,
no matter what procedure you have. Blood clots and pneumonia are directly
related to decreased mobility post-op. Good luck.
— DianeN
October 28, 2001
I had an open rny and don't regret my decision at all. I wanted
a particular surgeon, and at the time, he didn't do lap rny's. He
has since taken another surgeon into the practice who does to lap
procedures. Having said that...I think it's best to go lap. Healing
and recovery time is shorter, it's less invasive, you are only in the
hospital for 2 days, you lessen the risk of developing a hernia.
— [Anonymous]
October 29, 2001
I had open RNY in January of 2001 and I really don't regret the surgery
"type". However, this summer I would occasionally wish that I had
had a lap, as my scar was still fairly new. However, in the year and a half
since I have been coming to this site, I have noticed a trend. I hope that
those that are lap "enthusiasts" won't slam me too much for
saying this. It seems to me that more people have complications when they
have a lap procedure. Now, I realize that there ARE complications with
opens as well. However, the TREND that I've noticed is that those that have
leaks and require further hospitalization are mostly lap procedures. Now, I
would have to fully agree that for those surgeons who are truly experts in
this field, the complication rate would have to be about the same as open.
I would definitely recommend that you investigate your surgeons experience
and don't let a surgeon perform lap on you that is not extremely
experienced. Maybe those that I have noticed with complications have been
from surgeons that are just beginning to do lap. I'm not sure. I took
comfort in knowing that my surgeon had an unobstructed visual field with my
surgery. Maybe, I am just justifying having my 5 inch scar- LOL. As far as
recovery time being easier/shorter? I would have to say that those things
are definitely individual. I was in the hospital 2 1/2 days. When I
returned home, I went right back to taking care of my family, with lifting
assistance from my mother. When I was 6 days post, I went to my son's
basketball game.(mind you, I told no one of this surgery, so I must have
been looking and feeling pretty good to not arouse suspicion). When I was 8
days post, I went back to my part time visiting nurse practice. People have
mentioned an increase in hernias with open. While common sense dictates
that this is true. Hernias for the most part and wound infections, are not
life-threatening. Other complications (leaks, sepsis,etc..)are life
threatening and seem to be more prevalent among lap patients. Just my
extremely humble observation and opinion. Remember, just research,
research, research..... Shelley
— Shelley.
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