Question:
What is the difference between open and lap RNY as far as recovery, risks, etctera?

I am wondering why have open and have the big scar, when you can have a lap and why do some doctors not like to do laps?    — Dawn H. (posted on August 2, 2001)

August 2, 2001
There are those that will tell you that they prefer Open because the Doctor can "see" what they are doing. Open is supposedly also a shorter operation because of that (no need to blow the patient up with gas etc). The longer you are under anesthesia, the greater the potential for problems. With the Open, the recovery time is 2-3 times longer than with the Lap. Some Dr's do open because they don't know how to perform the surgery lap. Also because it is a lot cheaper to perform the surgery lap (which is also why many people's insurance may only pay for hospitals performing open). Lastly, lap surgeons actually must undergo training to be able to handle the instruments while looking at a screen (or through virtual goggles) and it actually does take quite a bit of skill. I opted for the LAP mainly because I couldn't take off the minimum 6 weeks recovery time needed for the open. I have since found (through visiting several Open post ops from my support group) that the issue about pain and recovery time really is true. I had minor pain/discomfort while in the hospital and was pain free a lot sooner. However, my surgery took 3 1/2 hours whereas my Open friends took 45-1 1/2 hours. Also I have six small scars vs. 1 long one. I won't lie and say that I would've liked a long scar -- but I will say that I would have the surgery whether I had to have it Lap or Open.
   — Kimberly L.

August 2, 2001
I don't know why there is a persistant statement that lap takes much longer than open. My lap surgery took 1 hour and 15 minutes. I think there are many variables that affect time. Everything from patients starting weight, to variation in body structure to experience of the surgeon. My recovery was quick. I was in hospital 2 1/2 days, off meds after one day home. I have 3 one inch long scars, and 2 puncture wound size scars. Bottom line however, the best surgery is the one the surgeon you are seeing performs best. I am grateful I was able to have lap surgery with a great surgeon, but I would have had open if it was my only option. I am so happy to have had this surgery!
   — blank first name B.

August 2, 2001
Dawn -- I meant to say it was cheaper to perform the surgery open (excuse the typo). Rebecca -- Note the word "supposedly". Good luck in your choice Dawn!
   — Kimberly L.

August 2, 2001
I wouldn't get too caught up in this one -- either way, get the RNY! It takes just as long to recover internally from either, its just that you'll feel better quicker and be able to move around quicker from the lap. The lap surgeon needs MUCH more experience to get it just right than the open surgeon. However, I'd never get anyone to do either one unless they were EXTREMELY experienced! Internally, you still need to heal for 8 weeks before beginning any exercise program other than walking, or for vacuuming or lifting over 10 pounds due to the risk of hernia. The scars heal, they shrink in size as your tummy shrinks, and they get lighter and lighter as time passes. Either scar is worth it. I had open, I was on pain meds for 7 days - then none. that's not bad. My surgeon performed 4 surgeries on me at once in under 2 hours and I've had no complications whatsoever! I wish you the best, let the surgeon decide or help you decide based upon his experience.
   — Cindy H.

August 2, 2001
I feel like this is similar to the question regarding having a child through regular or c-section deliveries! I had 4 c-sections and still consider all of my deliveries 'regular'. Hopefully we all get the surgery we need, that our doctor is the most experienced in and our insurance covers. I see some mentions of different length of time for the actual surgeries as one possible difference. I have always heard and thought that the laps took longer, yet one poster said this is not true. I think that there is also the misconception about recovery lap vs. open. I had open RNY, was in the hospital for only 36 hours, took pain pills only 2 days after arriving home, had no drainage nor nasogastric tubes, had no problems with staples and am doing fine at 6 weeks post-op. Learning as we all do! Ultimately, I think that you can search for the doc that does the type of surgery you want, be it RNY, DS, gastric banding, open vs. lap, etc. Sometimes, it does boil down to geography, doc expertise and insurance though. Good luck in your choice.
   — Molly S.

August 2, 2001
This is covered in Barb Thompsons book. LAP has a easier recovery but the main advantage is a real low chance of hernia. I% or less with LAP, 30% for open.
   — bob-haller