Question:
What are the pros & cons of lap vs open surg?
I am considering surgery but need to know the benefits of having lap over open or open over lap. There's a surgeon locally who does the open and one 2 hours away who does the lap. While I'm pretty sure I want this surgery, which one should I have? Thank you. — Debi B. (posted on December 1, 2002)
December 1, 2002
Lap is less evasive than open. Your healing time is quicker with lap than
with open. Your surgeon will tell you if you qualify for one or both. I
believe it depends on the thickness of your mid-section which procedure
will be recommended. Good luck.
— Jan H.
December 1, 2002
I am sure someone else will point out the increased medical risks with
either the lap or the open....but here is my two cents worth. Like you, I
had a choice of having open surgery locally or traveling 2 hours for the
lap. I chose the latter. I spent 48 hours in the hospital (rather than 4- 5
days); I was off all pain meds in 4 days and back to work in 10 days. The
lap recovery is typically much easier and my 6 little holes are fading fast
afterless than 1 month. On the other hand, I think it is most important
that you choose the surgeon you trust with your life and one that you have
total confidence in his/her skills. My surgeon had done over 1500 lap rnys
not to mention thousands of other lap surgeries prior to that. I would
hesitate to go to a surgeon who only did lap occasionally. Good luck to
you.
— Charree K.
December 1, 2002
I also think it is the kind of training and experience your surgeon has. I
had LAP-RNY on October 8th. It was done by a surgeon who had at least 600
LAP-RNY procedures done, in fact he was the first to do that procedure in
New Jersey. When I researched the procedure, I knew from the onset that I
would not want this to be done as an open surgery. I had read and heard of
situations where people who have the open procedure have infections,
hernias and have to go back to the hospital to correct the procedure.
I am happy I made the choice that I did. Five holes and back to work a week
later. Had I rethought the process, I would still have the five holes but
not back to work for a bit more time. Down 48 lbs in almost 8 weeks.
— Steve B.
December 1, 2002
Had lap 11/12/02 now my surgeon has his pts go home the next day- no more
48 hrs. I bet it will be out pt surgery eventually
— Linda L.
December 1, 2002
I had my gallbladder removed LAP in 1994 after I had lost 125 lbs quickly.
I weighed 297 at surgery. It was the greatest and quick recovery. So when
I started on this quest for surgery I was insisting I wanted LAP RNY, but
the surgeon I chose won't do it because I fall into a category of super
obese - 432 lbs and 63.8 BMI. He admits there are other doctors in the
country that would do it but his reasoning is sound. The open is safest in
that he can get in quick, get the job done and get out, shortening the
length of anesthesia. Also, I guess sometimes if you have a really large
liver they have to resect a section of it and that is best done with an
open. While I am not thrilled as I know the recovery will be slower and
likely more painful, I also am comfortable with his explanation as to why
he won't do it.<p>I would ask the surgeon how many he has done at
your particular BMI and what problems there have been. Obviously the more
LAP procedures they have done the better they will be at it. If it truly
is a toss-up in your case, based on the surgeons assessment, then I would
go LAP.
— zoedogcbr
December 1, 2002
I had lap rny in May. I decided on the lap vs. open because of the shorter
recovery time and less scaring. I was able to go back to work after only
14 days. I have four kids it would have been difficult for me to be off my
feet for any extended period of time. Some people prefer open because it
is less time in surgery. My lap surgery took nearly 5 hours where as if I
had had open it would have been under 2 hours. However, I am only 31 and I
was in pretty good health so I still felt comfortable with the lap. Good
luck with your surgery, it truly is amazing. At six months post op I am
down 107 pounds. I went from a size 22/24 to a 6.
— Linda A.
December 1, 2002
I'm going to be the odd man out here. I have had both surgeries. My first
was done LAP in May. Unfortunately, my surgeon made a mistake, one he
would probably not have made if it had been done open. I had to have an
open surgery in July to fix the mistake. I was out of work for 6 months
and am just now getting back to work and only part time at that. Make sure
that the surgeon has done a LOT of LAP procedures. If he has not, the open
will give you the same results. I did not have much pain with either of
the surgeries. I was out of work for so long because I developed an ulcer
and it took several weeks after the second surgery before it was
discovered. By that time, I had been laying around in a hospital bed for
most of 4 months. I did nearly 6 weeks of rehab before I was able to come
home. Then I was home for 3 weeks before I was able to go back to work at
all.
— garw
December 1, 2002
My reasons for choosing open may seem bizarre to many, but I am one of
those people who push the envelope often and hard. I knew that if I had
the surgery and breezed thru it (much less pain and restrictions from LAP)
that I'd not follow the no heavy lifting restrictions and not take it
"easy" during the internal healing period. If I felt GOOD, why
treat myself as if I'm recouperating. With open I was forced to heal!
— [Deactivated Member]
December 1, 2002
You are definitely getting differening views, so I'll add one more! I am
having open. When I first starting doing research on it, I was sure I
wanted lap for all the reasons stated here. My surgeon only does open
however. He is the liver transplant/trauma surgeon and has good reasons.
He feels open is safer because you can see what you're doing better and
there's less risk of leaking because of that. And since leaking is one of
the most serious complications, I now feel better that I'm having open...
in 2 days!!!
— Kristy L.
December 2, 2002
The best kind (lap or open) is whatever the doctor is most comfortable
with. Choose the dr that YOU are most comfortable with and go with their
preference. There are plusses and minuses with each type, but in the end
the medical research shows that success is heavily dependent upon the
experience of the surgeon. That said, I had lap with no complications, even
though my dr had not done many lap surgeries before mine. If I had known
about the research I would have gone with open, but it turned out okay for
me. I think there is enough risk in any surgery without adding more!
— ctyst
December 2, 2002
I had the surgery open 4 weeks ago and had no problems. My doctor could do
the surgery LAP but was more comfortable doing it open, so that is the way
we went. I was in out in 2 hour and 5 minutes, closed cosmetically. I was
in the hospital for 3 days and off my pain meds in a week.
I think the key is to see which doctor you are most comfortable with and
check to see how many surgeries the dr who does them LAP has done.
— Kelly T.
December 2, 2002
I had open because that is what my Dr. recommended. I have read that the
risks are the same percentage wise for both types, just that they are
different risk. Like leaks with lap vs. hernias with open. I was in the
hopital 5 days (could wnt home earlier) and when I came home I was off all
pain medicine. I suggest that you discuss this with your Dr. and come to a
decision that you are both comfortable with.
— Sandy T.
December 2, 2002
How many surgeries do you want? OPENS have a 30% chance of devloping a
incisional hernia even if they follow doctors orders. LAP its near zero.
Recovery is faster with LAP, less pain ands shorter hospital stay. My
surgeon does LAP and even LAP revisions on super morbids with BMIs over 60
my wifes LAP was 1.5 hours so some surgeons times open and LAP are the
same. Its largely your surgheons skills and OR tools. LAP tools for high
bmis are expensive and not all hospitals have them. I am baxck from a
vacation of sorts and answering this my favorite question. Figuring I may
save some from needing another operation and at least those who choose open
understand the risk, and are prepared for another trip to the OR:(
— bob-haller
December 2, 2002
I agree with Bob Haller. I actually put off my surgery until the hospital
I used bought the expensive long lap instruments. And my surgeon preferred
lap whenever possible - The long lap instruments mean good news for thick
abdomens. I understand "robotic" lap surgery will maybe be even
better. If your surgeon's hands are a little shakey - robot like surgery
solves that problem.
— charlene M.
December 2, 2002
I had open on Tuesday. I was off pain medication on Wednesday and came home
on Thurday (Thanksgiving). I feel great.
— Lisa M.
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