Question:
Which to do?

I went on a consult with an open doctor, he told me that, lap caused more pulmonary emblolisms because you were in surgery longer and because they pumped up your stomach. He also said the complication rate was higher and that there were more infections with the openings, and less weight loss. It would seem to be from everything I have heard lap is the best way to go, please help tell me your choices and experiences. I am ready to go. Thanks Tammy    — tammy S. (posted on September 26, 2002)

September 25, 2002
Naturally he will sell HIS procedure. A EXPERIENCED LAP surgeon OR time is not much longer than a open. My wifes Jen OR time was 1.5 hours LAP with a starting BMI of about 60. Incisional hernias happen to 30% of opens, LAP near ZERO. Lap has a lower overall infection rate since the entire belly isnt opened up. The actual RNY preocedure is the SAME, its only a matter of access, LAP or OPEN does NOT affect loss amount. Since LAPs have less pain because theres less overall cutting, ands spend fewer days in the hospital and are easier able to get around and walk more the blood clot risk should be less. Your profile is private, what part of the country are you in? Perhaps someone can suggest a great surgeon in your area. ME? 2 days in hospital, back to work part time in just over a week, boredom was my big problem. Lost 120 pounds in 6 months and at chart weight in 8 months 183 pounds. <P> Lets see if this will post here? <P> Lap vs Open cost Does anyone know which costs less, lap or open surgery? (View) open VS lap Is is my personal bias, Lap vs open complications? (View) Emotional Issues Lap vs open RNY Having second thoughts about Lap vs Open RNY!!!! (View) Long Term Post-Ops BPD/DS ALL THOSE WHO ARE BPD/DS Lap vs Open (View) Post-Op Other Weight Issues Weight Gain Has anyone gained weight after RNY? (View) Pre-Op Surgery Types Lap vs open How is surgery type such as open vs lap RNY determined? (View) How does the surgeon determine weather you are a better candidate for Lap Vs. Open? (View) Lap vs Open Have Surgery Date But Can't Decide Between Lap or Open (View) LAP VS OPEN Has anyone had problems with Laperscopic Gastric Bypass? (View) Lap Vs Open Surgeons experience with lap vs open (View) Can anyone give me info. on which procedure is better-Lap rny or open rny? (View) I've finally be approved for RNY!! Now I am trying to decide lap vs. open. (View) Lap vs Open I have not decided yet to have open or lap RNY (View) Lap Vs Open Lap RNY or Open VGB... I can't decide what to do. Any input on why you chose the one you (View) LAP vs OPEN ? Why do so many more people have open RNY? Isn't LAP recovery quicker? (View) Scars-Bellydancing Lap vs Open - What about scars...always wanted to belly dance ;)......... (View) Time in Surgery Does anyone know the amount of time in surgery for lap vs open BPD/DS? (View)
   — bob-haller

September 25, 2002
Well it did not post well but all that is the librarys list of LAP vs Open if you put it in as a search.
   — bob-haller

September 26, 2002
Tammy, that is the first I have heard of lap causing more embolisms and more infections, and less weight loss. I can't believe a competent doctor would give out those types of stats! Perhaps you should of asked him for his statistics and which studies he looked at for that info! I don't know about the embolisms but I don't believe the complication rate is higher (open RNY has a 30% chance of hernia), and definitely no difference in weight loss amounts with lap vs. open. You are usually on the table longer with lap, that is true, but you have less scaring, and a quicker recovery. I chose lap for those reasons. You may want to look around for other docs, but I would definitely challenge this surgeon to produce the evidence.
   — Cindy R.

September 26, 2002
Hi there. Just thought I'd put my two cents in here. I originally thought I wanted Lap but changed my mind and decided on open after speaking to by surgeon and researching. Most of what your doctor told you is not blatently 'wrong' (except the weight loss thing) but he was clearly advocating for an open procedure. I must stress to you that the type of surgery can not be decided by anyone but YOU. YOU must take into consideration all of the facts. Don't choose the lap procedure just because you 'heard' it was easier. I personally choose open because of the lower statistical chance of complications from leaks, infection and non-surgical complications such as blood clots due to the length of surgery with lap. Now, having said that, I am a statistical person- to me- the way with technically the least complications is the best. By the way, my surgeon does both procedures and does not 'advocate' for either as long as you fit the lap criteria. So again- dont just choose the 'easy' way. Educate yourself about what's best for YOU based on your BMI, where you carry weight and your personal surgical and medical history. Good luck with your journey!
   — LMCLILLY

September 26, 2002
The safety of the procedures has everything to do with the experience of the particular surgeon. And the studies back that up (you can look it up on MedLine if you want). A surgeon experienced with lap WLS will have you on the table no longer than an experienced surgeon would for an open surgery. And the complication risks are similar. Bob is correct in that the risk for hernia is much lower for lap than open. And some say that there is less recovery time required for lap, although I have heard just as many lap folks say they were down for the count as open folks say they were up and about the next week. I think it depends on how your body and mind handle the surgery, personally. I guess my concern about this surgeon would be that he is not only not embracing new more advanced techniques, but not willing to even learn the truth about them. How do you know that he will do things according to the most current information available if he is so ill informed? That would make me uncomfortable. Best of luck to you!
   — ctyst

September 26, 2002
Like Bob said their is a greater chance of hernia with open. There is a greater chance of leaks with the lap..Other than the incision, the surgery is the exact same thing. I personally would choose another surgeon just for the fact that this one doesn't seem to be quite as honest as he should be. I am ending up with open b/c of my size..BMI of 61.7 and b/c the surgeon I wanted only does the open...I think it is a personal thing. There are many other types of wls and many differnt surgeons you could look into before making a final decision. What makes you feel comfortable is the most important thing. Terri open RNY 10/15/02
   — cherokey55