Question:
What's the benefit difference between Laproscopic RNY and Open RNY?

Besides apparently a shorter healing time between the two surgeries, how is it determined which one would be better for the individual getting the surgery? I don't think it's the size of the person at the time of surgery, because I've read many different profiles from different-sized people, and there doesn't seem to be a deciding factor due to size. Does one surgery seem to work better than the other? Not seeing that being a factor, either. Can an individual request one or the other?    — sunneegirl (posted on May 14, 2003)

May 14, 2003
Size is indeed the determining factor. It is a matter of how large you are and how comfortable your Doctor is. My Doctor was not comfortable doing Lap on me, but I suspect had I pressed and moaned he might have given in. The patient, on the other hand, may request (or demand) Open. I preferred open because I wanted the Docs to have a clear view of what they were doing. As it turned out, because my Gaul Bladder was such a challenge to the Docs, they would have reverted to Open even had we agreed on Lap.
   — [Deactivated Member]

May 14, 2003
Size does not necessarily matter. It depends on the skills of the surgeon and it also depends on the instruments available. The internal work done is the same with either, so whether it's lap or open has NO bearing on your results. The key thing is to find a surgeon that you absolutely trust and go with whatever he/she recommends for YOU. I've had both lap and open WLS. I had very little pain with either. I didn't have a pain pump and didn't take any pain meds. I'm a year out from the original (lap) and 10 months out from the open. I do not have a hernia and I healed quite well from both.
   — garw

May 14, 2003
Paula: The most deciding factor between the 2 should be your surgeon's expertise at LAP vs. OPEN. It is exactly the same surgery once they go "in", but who wouldn't choose less scarring & faster recovery (LAP) if that was an option and in a skilled surgeon's hands? Now, keep in mind, if doing LAP, you still have to sign a waiver saying that you understand the surgeon could very well revert to OPEN should a complication arise during a LAP procedure. With reference to size, the probable reason one 500 lb person with Dr. X can have LAP over another 500 lb person with Dr. Y is (1) surgical skill and (2) length of laparoscopic surgical tools. Your surgeon will decide which works best for you, I don't believe they give you an option. Of course, during my pre-op research, I chose to look for a doctor with the most LAP surgical skills/experience, because I wanted to do everything possible to prevent the OPEN procedure. I knew it would be harder for me, personally, to deal with one long scar than 5 small ones. While I knew that reverting to OPEN was always a possibility, I did everything within my power to prevent that (i.e., I researched every possible reason why a surgeon may have to revert to OPEN, and did everything I had to do to try and prevent it) Still, once they cut you, it's all in God's hands. You just pray that you've made the right choice in surgeon's, hospitals, etc. Be prepared, be informed, and don't ever take anything for granted. Ask questions of any medical professional who will listen. If your surgeon has a problem with anything you ask, run in the other direction & find yourself another surgeon....Best of luck! Amy***LAP RNY 04-09-03
   — Amy A.

May 14, 2003
The only times that "size" matters in lap surgery is when your liver is too large for the instruments, the hospital doesn't carry long enough tools for a deep penetration or you have large scarring that would interfer with the tools. Otherwise, it is whether your doctor thinks you're a good candidate for lap, whether he/she is skilled at it, etc. I chose my surgeon first and since at that time he only did open, that's what I took and so far I've been very lucky to have had no hernias (the biggest concern IMO when choosing open).
   — [Deactivated Member]