Question:
I had a doctors office tell me that laproscopic surgery isn't good.
I'm looking into having the surgery done but a doctor's office told me that laproscopic surgery isn't a good idea because most people have to have post op surgeries to correct things that go wrong. They then have to be opened up anyway to correct any post op problems. Does anyone have any opinion as to which type is better , the laproscopic or the breast bone insision ? — cinnamongirl (posted on September 11, 2002)
September 11, 2002
Brenda, I would assume tour surgeon does not offer Lap surgery, or does not
know how to do the procedure. Wonder where he or she got the facts on Lap
patients having problems.
I had Lap 5/6 down 75 pounds and have not had any problems at all.
There are people in my support group that have had open , and Lap, I think
for me the Lap was much less invasive and my recovery time was very fast.
It really is a personal choice, the end results are the same , you will
have a new great life.
Good luck on your upcoming journey
Hugs
— Jeri P.
September 11, 2002
Laparoscopic procedures often have complications because you are using a
camera and not the naked eye. I went in to surgery expecting to have
laparoscopic surgery and it turns out I have both! They worked for 5 hours
to do the surgery laparoscopic and had a complication and in the process of
fixing the complication, my surgeon sensed something was wrong and decided
to open me up. Then he found that my pouch was misformed and that the
staple line was breaking down and bleeding. My pouch was too big, too. When
I talked to the surgeon's assistant afterwards, she said they always
prepare to open a person up when they do laparoscopic because there is a
higher risk of complication.
— sammygirlwpc
September 11, 2002
Shame on that doctors office for leading you astray!
I am 9 months out from a lap rny. No complications - laps are being used
for many types of surgery now - "remote lapriscopy" is the newest
I think. Just find a surgeon that has had special training for laps - some
surgeons don't want to change to laps if they are doing ok with opens -
regardless if it is less painful and recovery is faster. One surgeon told
me he feels barbaric when he has to do open surgery verses a lap. Hope you
are a candidate - not everyone is.
— charlene M.
September 11, 2002
Let me tell you how and why I picked the lap rny and the surgeon who did my
procedure. I had researched all the various options and medical groups in
California. I picked the doctor who had the most procedures under his belt.
His lap record had the least amount of hernia repairs and leaks of all the
ones I checked. His mortality rate was .03% and his availability in wake of
a problem rising was superior to any. His credentials were impeccable, he
was Board Certified and there were no malpractice claims against him. His
seminar was informative and honest. His staff was more then supportive and
helpful. He made me feel comfortable and confident that I was in the most
caring and knowledgeable hands possible. I knew all the risks facing me and
I also knew all the benefits. I was not allowed to return to my home in So.
Calif. until he was confident that my well being and recovery were well on
its way. My advice to you is to be well informed with whomever you pick to
do your procedure and to make sure that when they wheel you into the
operating room that there are no doubts in your mind as to what you have
chosen to do. Good luck in your journey. I hope your outcome is a favorable
as mine has been.
— Sue A.
September 11, 2002
PS. To my previous posting. With the lap procedure I did not have to have
an NG tube or drain. Within two weeks I returned to work. Of all the women
in our support group, there are far more of them having problems from the
open rny then there are from the lap. Mainly they are having problems with
the incisions healing, hernias and severe nausea. I like the faster
recovery.
— Sue A.
September 11, 2002
Brenda, the most critical keywords when considering laparascopic surgery
are "experience and expertise". As a critical-care RN who has
assisted with laparascopic procedures, I knew that that was the approach
that I wanted with my WLS. I contacted every "reputable" surgeon
in my immediate area. Either they did not offer laparascopic surgery at
all, or those that did offer lap surgery were not offering WLS at all. The
"open" surgeons were very up-front that it was not in their best
interest to leave their very busy, successful, and established practices
and "go back to school" to learn the very intricate and
specialized techniques involved with laparascopy. The lap surgeons in my
area expressed some hesitancy in "jumping onto the WLS
bandwagon"....they felt that their practices would soon be overloaded
with "those patients" and they were not willing to limit their
practices or focus primarily on WLS services. Like the previous responder,
I then began to look for board-certified bariatric surgeons who specialized
in laparascopic surgery, and was fortunate to find one of the pioneers in
the field only one state away. It is important to note that in the hands
of an experienced lap surgeon, the complication rate is far below that of
any open surgery, there is far less post-op pain, and the recovery time is
dramatically faster. It is a common myth (often perpetuated by
"open" surgeons who do not offer laparascopy) that
"open" surgery is better because the surgeon can fully visualize
the surgical field. Laparascopic cameras can visualize the smallest nerves
and blood vessels far better than the naked eye....the key to a successful
lap surgery lies in the exquisitely trained hands of the surgeon. If that
skill is not there, then higher complication rates may certainly occur.
Four of us in my family have now had beautifully successful lap RNY
surgeries, and my older daughter is having her lap RNY next week....all
with the same surgeon who has performed over 1000 lap WLS with only two
mortalities on record, neither of which was directly related to the WLS
itself. Our surgical times ranged from 50 minutes to 1 hour/10
minutes...no complications...no ICU....no tubes/drains...home in two
days....back to work full-time in 8-14 days. Experience and expertise...do
your research and don't settle for less if lap surgery is your choice.
Best wishes to you!
— Diana T.
September 11, 2002
Easton, thats fairly close. Use my surgeon Dr Philip Schauer in pittsburgh.
LAP being done by experienced surgeons like mine is definetly better than
open, see my profile. As to follow up surgeries, 30 % of OPENS get at least
one incisional hernia. ALL those hernias require a follow up surgery. Thew
ernia rate for LAPS is near ZERO.
— bob-haller
September 11, 2002
If you look at the studies being done what they show is that the outcome of
the lap surgery depends heavily on the expertise of the surgeon. If you
find a dr you like that is experienced with open but not lap: GO WITH THE
OPEN. But if you find a great dr with plenty of lap and WLS experience: GO
FOR IT! I had the lap with a dr that had primarily performed open
surgeries. I think he had only done 20 or so before me. Had I known better,
I probably would have had my surgery open. Now I had no problems, but I WAS
in surgery for 4 1/2 hours which would have been more of a problem if I had
been larger or had more comorbids. I'll say that now he has several hundred
lap surgeries under his belt and I have heard that it only takes about 1
1/2 or 2 hours now. Good luck!
— ctyst
September 11, 2002
I had open VBG/RNY on May 23rd and returned to work in 12 days. I did not
have an NG tube or a drain. I was up walking around the same night as my
surgery. My doctor also tests for leaks while you are still open on the
table so I did not have to drink that awfull stuff. I did not have any
problems with my incision healing. I think after researching this for so
long I would choose open again. I have seen to many complications from the
Lap, like perferated bowels, and leaks that are not found till it is to
late. I live in Mt. Pocono, PA if you would like any info on my surgeon
you can email me at [email protected].
— Joani M.
September 12, 2002
Hey Brenda - I spoke to several doctors prior to choosing and it was
obvious to me that the doctors who tried to steer me away from the Lap were
doctors who weren't trained to do them. I guess it's bad for business.
When you consider not having the greater risk of leaks and infections and
add to that the longer recovery time, the choice was easy for me. I had it
done laproscopically and I was out of the hospital in 3 days, back at work
in one week and have absolutely no scars. The bottom line, however, is
that you have to do what's most comfortable to you. I would suggest doing
research on your own and not just at the word of physicians who don't
perform the procedure. I notice that you're in Easton, Pa. I live near
Somerville, NJ and if you check my profile, you can see where I had mine
done. My surgeon was awesome and he is a pioneer in the use of Lap
surgeries in many types of other procedures as well. Good luck to you. -
Mike
— Michael N.
September 12, 2002
It all depends on what you are comforable with. I went to surgeon that
does open and he told me all kinds of things that lap is not good. I then
went to a lap surgeon and compared the two. I felt I needed to get back to
work sooner so I chose the lap. I also did not have to worry about a
hernia which, everyone that I know that has had it opened had to have
another surgery to fix the hernia of course these were all done by the same
surgeon so it may have been his fault. I have 12 friends and family that
had it lap and they have had no problems, no second surgeries, no leaks,
and on weight loss I was ahead of the opens even though they weighed more
than me when starting. I was considered a "lightweight". So if
I were you I would talk to sugeons that do both and then compare. Whatever
you feel comfortable with will be your best answer. By the way, I had my
gallbladdar removed at the same time and my total time in the surgery was 1
1/2 hours. The open surgeon told me Lap would be 4-6 hours so that was not
true. I was up walking in 2 hours after recover, home on the 2nd day and
driving by the 4th day. Back to work in 10 days. Best of luck to you and
remember this is your decision.
— Robin B.
September 12, 2002
I had my open rny on July 8th of this year. I had an open because of
complications from a previous surgery, but if I had it to do over I would
have the open again. I have a very small incision compared to some I have
seen. Also, I had no drain tube or NG tube when I woke up. I was up walking
the halls within 3 hours of surgery. I went home after 4 days (I had to
stay an extra day because I had some work done on my ear while I was in the
hospital). I was cleaning my house and taking care of my kids the day I got
home. I returned to full duties at work after just two weeks. I probably
could have gone back sooner, but I was enjoying the time off. Knowing my
own medical history I felt more comfortable with an open procedure. There
are some strange things about my anatomy that don't lend themselves well to
lap. I think it really comes down to the skill of the surgeon as far as
long term results. If you find a surgeon who is skilled in laproscopic
methods you are much less likely to have bowel perforations and other
complications.Likewise, if you find a skilled surgeon to do your open
procedure you will have a better chance at avoiding hernias and the other
problems associated with that type of incision. I can tell you that with my
surgeon the number of open patients getting hernias is no where near 30%.
Bottom line: if you want the lap don't go to a surgeon that doesn't endorse
it - he's obviously not good at it. Whichever technique you decide on find
a surgeon that is educated and confident about the use of that procedure.
— Jenny S.
September 12, 2002
I agree with the posters who say the experience of the surgeon in doing lap
should be the biggest factor in your decision. I had open with a surgeon
who has done over 2,000 RNY's. He frankly stated that he'd done lap, and
that he personally experienced more complications with it than with open,
so he doesn't do it anymore. I appreciated his candor and that made me
trust him more, frankly. I also went with him because he has a
psychologist and dietician on staff, and requires attendance at weekly
support meetings for six months following surgery. That after-care was as
important to me as whether I had one scar (open) or several little ones
(lap). The only important difference I'm aware of is the hernia statistic.
Hernias ordinarily aren't life-threatening. But I think it's a very valid
concern whether you want to face the 25-30 percent odds of a hernia down
the line. On the other hand, having hernia repair surgery can get you
"back-doored" into the insurance company paying for at least part
of a TT if you have it done at the same time. (Of course *nobody* wants a
hernia in the first place, though.) Partial payment for an otherwise
not-covered TT can be a silver lining for those unfortunate enough to get a
hernia. As far as recovery time is concerned, I've seen enough posts here
to have the impression it isn't really different in practice, in terms of
hospital stay or time it takes to return to work. I'd love to see a poll
on that, 'cause you'd really think lap would be faster. Also, I don't
believe there's any backup to support the poster who suggested the
incidence of leaks and infections are higher with open than lap.
Cosmetically, my "open" scar (3 inches long) is literally
beginning to fade away even at four months out. It looks better than the 2
1/2 inch scar I have from a melanoma removal done by a plastic surgeon five
months ago. (That scar also still hurts sometimes, while the RNY one
doesn't). Go figure!
— Suzy C.
September 12, 2002
My surgeon does the laproscopic and has had very few complications from it.
There is also a surgeon that does it open that has had good luck too..so
it depends what your needs are.
— Jaye S.
September 12, 2002
Just to elaborate. LAP or Open the RNY surgery is the same. The difference
is a matter of access. Lap pierces small holes thru the muscle wall, open
cuts the muscle. That cut is what leads to hernias even if you follow the
no lifting for X months rules. Bottom line the actual surgeries are the
same. <P> Lap has certain advantages, generally shorter hospital stay
1 to 2 days, opens 3 or more, easier recovery with less pain because there
were fewer cuts in your body. The actual LAP surgery costs more but
insurance is willing to pay because of the shorter hospital stay, that
saves them money.<P> It truly isnt your choice, it all a matter of
what your surgeon is comfortable doing. A experienced LAP sugeons OR time
is around 1.5 hours around the same as a open surgeon. I enncourage
everyone to research thoroughly their surgeon. Experience matters much, as
well as support staff and aftercare.<P> I think EVERY surgeon should
require psych, nutrition, sleep studies, and all other pre op testing as
well as attendance in a free or very low cost support group. Other signs of
good surgeons are MO friendly offices with bariatric sized wheelchairs and
fast knowledgable off hours return of phone calls.<P> To ME these are
the markers of a good surgeon.
— bob-haller
September 12, 2002
hi :) i had open rny on feb 8 02. i at first thought my surgeon would do
lap but he does not. and at first i was scared upon learning this. but
after he told me his reasoning i was ok with it. he said he preferrred to
do open so he could be right in there seeing everything he was doing with
his own eyes and he also made triple sure everything had been stitched up
securely. i felt better with it after he explained everyrthing to me.
— carrie M.
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