Question:
If given the option -lap vs. open- which would you do & why?
Curious to hear from anyone who opted for an open if lap was an option. At Pacific Bariatrics it takes an extra 6 to 8 weeks for lap procedure. Not sure the wait is worth it. — Brenda C. (posted on April 22, 2003)
April 22, 2003
hi brenda, i am pre-op, i feel safe having my surgery open because every
thing is right there out in front of the surgeon. i feel that the lap
operation wouldnt give the dr enough sight. i would be scared of getting
all knicked up inside. but if that were the case surgeries wouldnt be done
as lap, huh! so this is just my view on this!
— TIFFANY R.
April 22, 2003
I am having open on June 3 and I agree with Tiffany
Autumn
— Autumn
April 22, 2003
I had Lap RNY surgery 9 weeks ago. I chose it because that's the preferred
procedure of my surgeon who has an impecable reputation. When he asked me
which one I wanted, I said I thought you did Lap. He said yes, that's the
way he most oftern did it. I told him he could cut me however he wanted,
from my necck to my navel if need be, to make the surgery as safe as
possible. Have confidence in your surgeon, and then you will be
comfortable with the type of procedure---Lap vs open. As some of the
others have said, there are many thoughts and preferences on the subject.
I preferred smaller scars, (not that I'll EVER wear a bikini) because I
wasn't too keen on the number of open RNYers that have had extensive wound
draining and more frequent hernias, long term. However, as I said, I would
have done it open if that's what my Dr. did as routine. Good luck!!
— Fixnmyself
April 22, 2003
Well, my surgeon does both surgeries but prefers Lap when possible. She
stated that she can actually see better doing Lap because everything is
magnified on the screen. The other plus is the healing time with Lap is at
least half the time plus there is more drain, wound care and hernia
problems with Open. I had my Lap on February 12th, 2003 and was back to
work on February 24th. But then, I work at a desk for an insurance company.
You will just have to make a list of Pros and Cons and decide :) I am very
happy with my decision! Best of luck!!
Peggy 287/229 @ 9 weeks out :)
— Peggy B.
April 22, 2003
I had the option of either one. I chose the lap because of less scarring
and shorter recovery time. I have a full time job and four kids I needed
to be back on my feet ASAP. However, the lap is also a longer procedure.
Mine took about 4 hours where as open would have only been about 1 1/2
hours.
— Linda A.
April 22, 2003
Hi Brenda-
For me i didnt care about the scar, All i know is that i wanted to have
this surgery and i didnt care how i got it.I had open. My scar is about 4
inches long and 19 months later it is very faded and i even can wear a 2
piece swimsuit.
— msski
April 22, 2003
Hi! I had my choice of lap or open; at first, I wanted to go with lap,
figured it was a no-brainer. But the more I researched it, the less sure I
became. I finally decided on open after considering the pros and cons of
each, and how they applied to ME, specifically. The cons of lap to me were
mainly the increased surgical time and the fact that they do a double
anastomosis with open but not with the lap (with open, they can essentially
double stitch the new "connections"), helping to ensure a more
secure outcome. The pros of lap were less scarring, and probably a quicker
recovery time in terms of muscle soreness, incisional healing, etc. The
cons of open were a bigger and more invasive incision, and a much bigger
scar, so longer healing time. The pros of open were that in the program I
went to (Cleveland Center for Bariatric Surgery), they have two surgeons
scrubbing in on open procedures, so the OR time is considerably less.
There's the aforementioned double anastomosis. And then there's the feeling
I sort of had that if someone was going to be rearranging my intestines, I
wanted them to have a really good view and the ability to get "hands
on" if needed. I didn't particularly care about the big scar, because
even if I lost all the weight I wanted, I am not the bikini sort of woman,
so no one would be seeing it anyway.
I opted for open, and am now 11 weeks out and down 48 pounds. I have been
happy with my choice, have had no complications, and the scar isn't half as
bad as I expected it to be. I would advise that you thoroughly examine each
of your options, and if one choice doesn't jump out at you, then make a
list of the pros and cons of each, discuss it with your surgeon, and then
make the decision that's most appropriate for you.
— johanniter
April 22, 2003
I had open only because of my size. My scar is not bad at all it's a bout
2 1/2 inches and you can barely see it. The problem with the open is the
pain. IT HURTS!!! And I was in serious pain for 4 weeks. My friend had lap
and she was back to work in a week.
— Kimmie C.
April 23, 2003
I opted for lap because I needed to be back on my feet and back at work as
soon as possible (only two of us nurses here). My surgeon is very
experienced in lap procedures of different types and especially RNY, so I
knew I was in good hands. (He teaches other docs how to do it!) I think my
surgery only took 1 1/2 to 2 hours, and that's about how long my husband's
took also. I had no problems with him being able to see everything -
experienced lap surgeons can see everything in there just as well as in an
open surgery. (I think the camera can even zoom in closer for an even
better look than with the naked eye.) I do believe I would have waited for
the lap. We have a surgeon in network that only does open, and I probably
could have gotten in sooner with him, but I preferred the lap procedure.
— koogy
April 23, 2003
My surgeon only performs the open RNY and I am glad. My scar is minimal,
and I didn't have the horrible pain that people have talked about (I had a
feeding tube-different story-that hurt), but the open RNY was great. I
felt a little more comfortable with open than LAP. My surgery was a very
long one becuase my surgeon also took out my gullbladder, and he puts a
band at the bottom of the pouch as well, I believe it was 4 1/2 hours, and
I was still back to work the very next week. I think it depends on your
pain tolerance, and how well your surgeon is.
— sheri H.
April 23, 2003
Brenda,
I did allot of research before surgery, my husband wanted me have it done
lap, (My surgeon would have done either) so no problem there, how-ever I
wanted open, I read somewhere, with Open, you're up for more minor
complications and less major, and that's what I wanted...... versus lap,
more major less minor.....
So I had it done Open, have about an 8 inch scar, I'm not vain, and have
no problem showing off my tummy, if they ask I tell them.... no quams here
! I'm proud of what I've done and what I've learned. It's been a real
challenege !.
Best of luck deciding.
Post op 11 months down 128 pounds
— tannedtigress
April 23, 2003
Opens are at as much as 30% chance of devloping a hernia, with lap the
incisional hernia rate is near zero. Lap has less pain because theres less
trauma cutting to the body. The actual surgery is the same its only a
matter of access. Insurance pays for the more costly LAP because it saves
on expensive hospital days. Most of my surgeons patients are only in the
hospital for 1.5 to 2 days. Opens are generally more. If your job or
lifestyle involves heavy lifting or lots of activities LAP is prefered.
Actually it really up to your surgeon, his skills and tools. Espically for
the super morbids. Extra long lap tools for 500 pounders cost big bucks.
Under magnification lap has better view than open. My surgeons lap table
time is aboiut 1.5 to 2 hours the same as many opens.Either way WLS works.
— Sam J.
April 23, 2003
I would go with whichever procedure your surgeon of choice has more
experience and confidence with. If the surgeon is very skilled at lap, that
would always be my preference (easier recovery, less risk of hernia, nearly
invisible scars), but that's a BIG "if". There is a large
learning curve with lap procedures, and I wouldn't want to be someone's
fifth lap patient, or even their fiftieth. Also, many doctors take
shortcuts in order to reduce time under anesthesia (e.g., they don't
oversew the anastomoses during lap procedures, etc.). Make sure to quiz
your doctor carefully about the procedures that will be used, the extent of
their lap experience, and their specific mortality and morbidity rates for
lap vs. open (if either of those is higher for lap, that's a definite
warning sign). Ask specifically about leaks and conversion rates (a skilled
lap surgeon should only VERY rarely have to convert from lap to open
mid-procedure). Hope this helps -- good luck!
— Tally
April 23, 2003
Personally, I would only go for lap because, well, I'm a wussy. I do not
handle pain well and <i>most</i> people will tell you that lap
is less painful because of the very small incisions versus one large one.
The other thing that sold me was the possibilty of incisional hernias. With
open, a large numbr of patients get one (or more) and with lap, its almost
none. I had originally planned on open soley because it was $2000 cheaper,
but once I did the research, I knew that it was going to be worth it. I
knew there was always the possiblity my surgeon would have to open me up if
lap as not an option, and I would have been fine with that. But my recovery
with lap was really nothing (except I pulled a muscle at my pouch) and I
returned to work in 12 days! I do have to say though, I have a friend who
had open with Pacific Bariatrics and did wonderfully- quick recovery,
minimal pain, but I think she is not in the majority. Would I wait 6 to 8
weeks for lap? Definitly, but like I said, I'm such a wimp. Best of luck to
you!!!.....Karen (lap rny- 09/20/02- down 127 pounds!)
— karmiausnic
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