Mrs Squishy and I had planned on having Lap, but our surgeon talked us into open. His reasoning was that at 46 years old, he wanted the opportunity to look and feel around while he was in there to make sure there were no other problems so that we would never have to be opened up again. Also, he dis some additional stitching to hold everything in place properly so that the chances of things twisting later are minimal. He said that this was not possible during a Lap procedure. He showed us pictures of many of the things he encountered unexpectedly and repaired when he opened people up.
As it turned out, we were both grateful that we had open because he found problems in both of us that he took care of while he was in there. With Jane, aks "Mrs Squishy", I received a call from the surgeon in the operating room requesting permission to do a hysterectomy. Turned out, she had a large benign tumor (the size of a football). He also found her gall bladder was full of stones and her appendix had some scarring that indicated that she had had some appendicitus, so he took them both out. It is unlikely he would have seen any of those problems if he had done it Lap. This would have probably resulted in two additional surgeries had he not done it while he was in there doing the bypass.
In my case, I had a previous laparoscopic gall bladder removal, and the scar tissue was causing problems. Apparently it had kind of spider webbed out and grabbed everything around it and pulled it up under my rib cage. There is some kind of curtain of tissue between your abdominal muscles and your internal organs. It had grabbed that and pulled it up under my ribs along with some organs. He spent an extra hour and a half cutting everything back down so it was hanging where it was supposed to be before he could do the bypass. If he had started out Lap, he would have certainly had to open me anyway because there was no way he could have done all that Lap.
Oh yeah...He also repaired umbilical herinias in both of us that we didn't know we had.
The recovery is probably a little more uncomfortable with open, but I did not personally think it was any worse than my previous Lap gall bladder recovery once I got home. The only difference was with the gall bladder, I went home the same day and with the open bypass, I was in the hospital for a couple days after. If you add up the length of the Lap scars, they are probably equal to the length of the one open scar. My Lap scars are almost invisible now, and it has been about 4 years. I'd say they were pretty invisible after a couple years. Can't say about the open scar because it is too new.
The chances of getting a hernia are also a little higher with open because they cut all those muscles and put them back together. For the most part, as long as you follow the lifting restrictions in the first 6 to 8 weeks, that should not be a problem, though.
I have a brother who had a Lap procedure in November and has had no problems with it at all (Lost 140 pounds so far). He had it on a Monday and was back to work on Friday. He never even told anyone that he had it done. I had mine on a Wednesday, came home on Friday and took the next week off at home. I would not advise going back to work as fast as he did. He didn't have any problems with it, but c'mon...take a little break to heal.
I don't think there is a right or wrong answer, so you can't go wrong either way. If you found a surgeon that is that good, I would not hesitate to have open.
I hope this helps.
-Mike-