Question:
Does anyone know which is better? Lap or Open?
I have made my decision to have open RNY but people ask me why? I have the choice to do it the other way but the way I look at it is that they can see everything they are doing better if it is done open vs. lap. Any info? — Melissa K. (posted on September 25, 2003)
September 25, 2003
I thought I was having LAP up until I found out I am having OPEN - Surgery
date 10/22/03. I freaked out and questioned this I was told that with LAP
I would be under 2X longer than with OPEN. I was told that my surgeon
feels it safer to do OPEN and that sometimes they do LAP and end up having
to do OPEN anyway. So whatever you decide I wish the best.
— Mildred M.
September 25, 2003
My surgeon is of course trained to do both. I did lap because the recovery
time is much quicker. Scaring is minimal vs. open. If your surgeron feels
he/she can't see everything that is needed, they will open you
anyway...they are highly skilled and trained professionals. I trusted mine
to make the decision. I went in knowing that there may be a possibility
that it may have been done open. I never had stitches...just steri-strips.
HTH.
— Lynette H.
September 25, 2003
It depends on your surgeon. If your surgeon is highly trained, the risk for
complications is somewhat lower (especially for hernias). My surgeon is
trained in advanced laproscopy and can "see" better lap than
open. Because he is highly skilled, it takes him no longer to do lap than
open. Recovery is much easier and quicker with lap. You are usuallly up and
about in half the recovery time. If my surgeon was equally skilled in both
areas, I'd go lap, hands down. Of course, they will all tell you that they
can begin lap and if they run into a problem, will revert to open. My
surgeon tells us that but also tells us that he has never had to revert.
— Denise B.
September 25, 2003
I had my surgery done "lap" on Sept. 19th. Not sure if it's me or
having the lap surgery, but I am already up and around and roaring to go!!
— Lynnie B.
September 25, 2003
Since I had open gall bladder surgery a number of years ago, I had no
choice with my RNY surgery. It will be done "open". However, I
am content with that decision. With open I will be in surgery much less
time which I see as a definite plus since I have sleep apnea and some minor
heart things. My husband is much more comfortable with me having open as
it will mean less surgery time too. I healed fairly quickly with the gall
bladder surgery, so know this will be OK too. Given the choice, I would
still go with the open RNY for me.
— [Deactivated Member]
September 25, 2003
You have opened a can or worms. I had open gallbladder but lap RNY.
Recovery was much faster. Far less chance of hernia, less scarring, and
according to medical program I saw last week, much less chance of
infection. It depends on the experience of your surgeon. It is an
individual decision.
— Dianne C.
September 25, 2003
I did Open RNY b/c I went to BTC and thats what they do. I would of loved a
little less pain, but I did feel safer, seeing how they saw everything with
there own eyes and not through a scope. I had my gallbladder and tubes tied
within a year before WLS and it was lap, but they are more common and
easier surgery. The scar does'nt phase me either, it just looks like I had
surgery lol. Everyone chooses what they want just like you will :o) Good
luck on your journey to hapiness either way you go!
— Sandy M.
September 25, 2003
The best choice is the one that your surgeon is better at. Mine was an
expert in laproscopic procedures, and feels he sees better with the
magnification. An accomplished lap surgeon can do the surgery relatively
quickly. I chose lap because I could not afford much down time. I was up
and around in a matter of days. The hernia risk is lower too. If your
surgeon is not exceptionally skilled in laproscopic procedures, I would go
w/ the open.
— mom2jtx3
September 25, 2003
All of you opens must have had quite the speedy sugeries! I had lap rny
and was done in 90 minutes. But, in the end, you have to decide what YOU
are comfortable with. For me, I had three kids (8,6,5 at the time), and
homeschooling to think about. I had surgery on a Friday morning and was
taking care of the kids on my own by Monday. It also helped that my
surgeon had extensive training in (and specializes in) lap procedures. Go
with your gut though...no pun intended!
— eaamc
September 25, 2003
I wanted open because I think the surgeon has a better view of the
operating field - especially when you are as heavy as I was (I know that
some of the lap people will disagree with this). I had my surgery and was
released to return to work in 12 days. Also, my surgery, which included
the RNY, gall bladder and repair of a hernia lasted only a little over an
hour. Actually, my surgeon said mine took longer than most because I was
so heavy - I weighed 346 pounds. He normally does the surgery in about 50
minutes.
— Patty_Butler
September 25, 2003
I was insistent on LAP, but a very important consideration is what your
surgeon is best trained to do. My surgeon had done 500 LAP's before me and
I was convinced. Had the LAP 10/8/02 and am down 129. The best thing I ever
did. Lots of luck to you.
— Steve B.
September 25, 2003
I know of a surgeon that tried to make open sound more safe than Lap but I
think that was because he wasn't proficient at Lap. My surgeon is very
experienced at Lap. I think what Steve said is key - what is your surgeon
most experienced with doing? If that is Lap, then go for it. I believe
they get a real good look in there even with the Lap. If your doctor
hasn't done very many Lap's then maybe you should consider having it open.
Aside from the obvious issue of quicker recovery, I think that Lap's are
generally under for a shorter period of time which is also a good thing.
— Judy R.
September 25, 2003
My surgeon does lap also and when I asked him, but don't you see better
using the naked eye with open, he laughed and said, with lap you have
magnification which allows you to see much more detail than the naked eye.
Nuff said.
— Cindy R.
September 25, 2003
It is up to you and your surgeon. However, If I had not had open then they
would not have found a problem that had not showed up on any x-ray or test
and would have caused me to have anyother surgery in the future.
— Oldsoul
September 25, 2003
It should be up to you and your surgeon and what you both feel comofortable
with...I do know that with Lap the recovery pain is less, you have less of
a chance of getting wound infections and you will have smaller scars. That
is why Laparoscopic surgery is becoming so popular (within the past 10
years) for common procedures like appendectomies and cholecystectomies and
now gastric bypass.
— Kara J.
September 25, 2003
The people who go open just about always do it on the advice of their
Doctors. I think some Drs. are just not skilled enough at lap to do it. I
investigated and looked at the stats. There really is no difference in
mortality rates, and complications for most things (like leaks) appear to
be comparable. BUT - lap had far fewer hernia complications and far less
initial pain. So I chose lap and then went out and found the best
laparoscopic doctors in my area. I cannot imagine why anyone would choose
to go open. But I do know that if someone is over 350 lbs my Drs prefer to
do it open. And sometimes there are other reasons that necessitate a person
going open. ( By the way, really skilled lap doctors can do the procedure
almost as quick as the open now. The lap procedure has come a long way,
just as with gall bladder surgery it will soon be the standard operation.)
— linda A.
September 25, 2003
The important thing is the loss is the SAME. LAP or Open doesnt effect how
much you loose. This is all covered in Barb Thompsons great book, see the
very bottom of my profile for a link to the book. My wifes BMI was over 60
her LAP took 1.5 hours. You first pick the surgery you want then find a
surgeon who does it. Insurance pays for LAP, which costs more because it
saves hospital days. My stay was 2 days but I wanted to go home in a day
and a half. Thats the length of stay now if the patient has no
complications.
— bob-haller
September 25, 2003
This is sort of a loaded question....What is most important is not which
one is better....It is which one is your surgeon more skilled and has
experience doing.It is a myth that surgeon's can see better when doing the
surgery open as there is new technological equipment for doing it lap,that
allows surgeons to see everything in 3D.I've seen where people have said
that it takes longer doing it lap but the more experienced lap surgeons can
get the surgery done in the same amount of time as an open surgery.The only
reason that I chose to have it done lap was because that was my surgeons
forte.
— jennifer A.
September 29, 2003
Well, remember, you were asking for peoples' opinions. Congrats on your
decision to have the surgery - it will change your life. My opinion is
somewhat like the others...it's about the skill your surgeon has and your
comfort level with the surgeon. I am a big baby and if I was able to
qualify for lap, I was going to do it that way so I sought out the best lap
surgeon I could find. His answer to your question is "lap is
better" and he says it is because the laporascope (sp?) magnifies
things so much that you actually can do closer work - stitching, stapling,
etc. A friend at work is such a great wls example and he went to a surgeon
that only does open...his surgeon says that he only does it open because he
said he feels he'd need to have about 30 lap surgeries before he felt
comfortable with it and he did not want 30 obese patients to be his guinie
pig...so he offers open and has a line outside his door. I can tell you
that people who had open hte same day as me healed just as quickly without
a lot of pain so I don't think there is much difference - it is your
choice.
— Donya P.
September 29, 2003
Again, go with what your surgeon does best, that is, if you choose a
surgeon first and then choose the procedure. Keep in mind that surgeons who
do not offer lap may not have been trained in those procedures yet. It
takes a LONG time to be trained and to get good at it. It also costs quite
a bit of money for the training and the equipment. Some surgeons who offer
lap only to those of us below a certain BMI or weight may not have the lap
equipment to do the procedure on those of us who are superMO (very
expensive instruments!). So, there are a whole variety of reasons some
surgeons only do open and why some will only do lap on certain-sized
people. In my case, I had lap RNY because that's what my surgeon decided (I
did want lap anyway)-- my surgeon starts all RNYs as lap, then converts to
open if necessary. I felt comfortable with this. You need to do what makes
you feel the most comfortable.
— lizinPA
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