Question:
Is a Laproscopy RNY procedure reversable & return to work

During our consultation, our surgeon told my husband and me that he only performs OPEN RNYs in his practice because the LAP RNY procedures are not reversable and there is more risk. Can anyone provide information on this? Also, what is the difference between distal & proximal. Are patients supposed to tell the doctor which type of RNY (distal or proximal) they want to have? One other question I have is about the return to work after an open RNY. My husband thinks he will be able to return to his desk job in one week. Could some of you share how long you were out of the office due to your surgery and tell which kind of surgery (OPEN or LAP) you had? Thanks in advance to all who reply. :)    — [Anonymous] (posted on February 18, 2001)

February 17, 2001
Hello, I'm not real sure on the proximal and distal question. So, I'll leave that one to someone on here who knows more about it. Neither surgery is suppose to be considered reversible. This is for life. Now, surgeons will reverse it only if you have some major medical complications that can't be corrected any other way. I had Lap RNY on 12/5/00 and I went back to work on 12/16/00. I have a desk job. I just took my pain meds to work with me. My co-workers understood that I was in discomfort and I wasn't my usual happy self. Good luck to you.
   — Angela E.

February 18, 2001
According to my surgeon, the actual surgical procedure is the same, whether it is lap or open. Any portions which are reversible done open, are reversible done lap. Perhaps he meant that any reversal procedure would need to be done open? In my experience, it was during the discussion with my surgeon that we determined the best type of surgery, and a similar discussion may happen for you. You may have an idea which is best for you, and your surgeon should be able to explain the pros and cons from his point of view on the distal / proximal issue. In my own case, reduced food intake was unlikely to be enough to control my weight, and I opted for a distal procedure to insure an ongoing malabsorption (my surgery was actually the DS). Back to work in one week? Boy - that would be tough, very tough. Even with my lap procedure and an excellent, uneventful recovery, I would have been pretty miserable working at one week. I could have gone back at two weeks, was glad I stayed out 3. I am encouraging my husband to plan for 4 weeks for his surgery (I was in better shape than he is)!
   — kateseidel

February 18, 2001
My surgeon specializes in laparascopic bariatric surgery. He states that the lap RNY is completely reversible, but that only 1% of his surgery patients have actually required reversal due to excessive weight loss. Proximal and distal refer to the amount of intestine bypassed...proximal being shorter, and distal being longer. Many surgeons make their decision on the amount of bypassed intestine based on the patient's starting weight versus the goal weight....the more that the patient needs to lose, the more distal the procedure . My daughter and I both had lap RNY surgery. I returned to a full-time office position in 8 days; my daughter returned to full-time teaching of 4 year-olds, in 14 days. Please let your body be your guide when determining your return to work...we all have different tolerance levels. WLS is still a major surgery, regardless of whether the procedure is done laparscopically or open. Your body requires adequate rest and sleep for optimal healing. Don't cheat yourself unnecessarily...you will only pay for it later with increased fatigue, weakness, irritability, depression, etc... Get help with housework and childcare if possible...this is also not the time to prove what a "strong" person you are or to try to live up to the accomplishments of other post-ops. You've waited a long time for a "new life"...relax and enjoy the journey. Good luck to you!
   — Diana T.

February 18, 2001
I had open RNY on a Tuesday, was home from hospital on a Sunday. I returned to work half days at 4 weeks. You cannot lift over 10 pounds for up to 8 weeks so you will have sufficient time to heal, not only the exterior scar but the internal ones. Otherwise, you will hate yourself for developing a hernia! Also, no vacuuming or shoveling, etc. You should never return to driving while still on pain medications!!!! And, another thing about driving -- should you have to suddenly slam on your brakes -- watch out! The best advice is to take the time off necessary to heal and regain your strength. This is a MAJOR, major surgery will a lot of rerouting of our insides! You should listen to your body and if it says 'rest' then REST. Don't try to be a superman or superwoman. It won't be worth it. Follow the doctor's advice, he knows what he's talking about. Best wishes. P.S. My surgeon bypasses 5 to 6 feet on all his RNY patients, and he performs a vagotomy on all also -- this is to reduce the chances of developing an ulcer (althought not too many surgeons have the expertise to perform this).
   — Cindy H.

February 18, 2001
You asked a LOT of questions in a small space here. In reading between the lines, what I see is that if your surgeon does Lap, the stomach will be transected. If he does Open, you will be dependent upon the staple line. Having had the staple line originally, I can say that given a choice, transected is the only way to go, since my procedure basically reversed itself by disrupting the staple line. No, I didn't out eat it. The body rejects the staples, some go fast, some take years, a few never do. Then, you asked about distal vs proximal. With any RNY, you will eventually need supplements for maximum health & wt loss, however with distal, the dosage will be much higher. However, the wt maintainence is easier. And for some like me, that is the preference. I can put things IN my face, like supplements. It was keeping them out that was the problem. The Proximals still need to cover the same bases, but much lower doses. They have to work a little harder to maintain their wt once they get there. And many prefer THAT. In real life, most docs issue a "one size fits all" surgery. My docs here customize to present weight, lifestyle, desired goal, but that is not common. I was in terrible health pre-op, so was not working full time, anyway, however I was able to go back to my desk job part of the part time within 2 weeks. However, I was more ill from my obesity than from the surgery itself.
   — vitalady