Open Vs Lap Procedure - ThinnerTimes

fitbefore40 · 02-14-2006, 12:49 PM

Ok - on my scheduling call, the nurse asked if I had decided between the open Vs the laproscopic RNY. My Dr has done 2000 + open and over 200 lap, but the lap complication rate is almost 40% higher than the open complication rate. Plus, the lap RNY is a longer procedure - I'm trying to stay under 4 hours for anesthesia due to complications with anesthesia I had on 4 prior surgeries. And finally, he does not take out your gallbladder with the lap RNY.

What did everyone else do? I know this is my decision and I have to weigh everything . .. but I love you guys!

Thanks. Laurie

Doc J · 02-14-2006, 01:06 PM

I had lap and my surgeon's complication rate was lower for lap. Why would you want your Gall Bladder removed if it was healthy?

Danniboi · 02-14-2006, 01:44 PM

DONT GET YOUR GALLBLADDER REMOVED!!!

...Unless you have Gallstones or some other gallbladder ailment. My wife was told that she had to have her gallbladder removed when she suffered from Gallstones. She has had terrible problems with acid reflux ever since. I understand that this is rare, but why would you remove an organ if was operating correctly.

Now as to lap vs open...

Open is safer but only because it is a mucher quicker proceedure, just under an hour vs 2-2.5 hours for the lap. I went with the lap proceedure because I wasn't crazy about being filleted open like a fish, the recovery time involved with the open proceedure is 2 to 3 times longer. With the lap I was back to work in 2 weeks, and I felt like I could have gone back even sooner.

RAY W · 02-14-2006, 01:45 PM

My Doctor Has Done Over 2000 Lap He Will Not Even Give The Option. He Decided Wich Way To Do It I Guess If You Want Lap I Was Only Under About 2 Hours. If You Have To Look For A More Experienced Lap Surgeon.

fitbefore40 · 02-14-2006, 01:58 PM

You guys are so nice to reply so fast. I do not know if my gallbladder is diseased or not. My sister and mother (both normal weight) both had to have their gallbladders removed at one time or another in their lives. I have not had any pain, but if genetics play into this, I may have a gallstones and not even know it.

If my Dr didn't have such a LOW complication rate for open surgeries, the lap complication rate wouldn't look so bad. I asked for numbers on EVERYTHING - He has never lost a patient on the table, he has lost 2 from complications - one from ARDS and the other from a leak. Now he requires everyone to do a sleep study before surgery and some sort of leak x-ray thing prior to leaving the hospital.

I guess most people would be more afraid of the open - but I've had 2 c-Sections and 4 open knee surgeries . . . . I'm more afraid of being pumped up with gas for the lap!!! And you know, on the c-sections - I was awake - nothing can be worse than smelling your own flesh as they use the cauterising scalpel thingy!!

Thanks for helping me . . . everyone!

LisaBoston · 02-14-2006, 02:16 PM

Well I had open 14 days ago and doing really well. I too had the option and my doctor is more experienced in open plus I really wanted him to be able to see inside to make sure everythhing was ok. I really suggest you having out your gallbladder at the same time. Gallstones are not fun and very common after WLS.

Others could say that lap is easier to recover after and they have had no complicatons. I have also heard that lap and open are the same for complications - just different ones. Open you have 1 large wound which could get infected.

I don't live very close to my doctor and that was another reason for having open. With the complications slightly higher with lap, I didn't want to take any chances. I would be concerned about your previous problems with anesthetic. I too didn't want to be "under" double the length of time.

My doctor books 1.75 hrs OR time for OPEN, and 4 hrs for LAP (not that it takes that long) He said the time for LAP is about double than OPEN. Remember every doctor has different times due to experience.

You should really talk about the choice that is best for you with your doctor as he knows your situation.

What I can tell you is that I am VERY HAPPY with my choice to have open procedure and very happy that I don't have a gallbladder.

My wound is healed up now and its only been 2 weeks. I feel pretty good. Had no complications and just spending my time healing.

Best to you and your decision.

Dave · 02-14-2006, 02:40 PM

I've heard that with open you have a much higher chance of getting a hernia. One lady had open surgery four years ago and she has had eight hernias. Her doc told her it's because of the open proceedure. I also didn't want to feel like I was gutted so I went lap, which is all my doc does unless something goes wrong and he has to open you up. I would think worse case you go lap and if something goes wrong he opens you up.

Ryn · 02-14-2006, 02:47 PM

My surgeon only does open procedures. So that took the option out of my hands. I had a gallstone and did not even know it so he removed it at the same time.

amazonbeauty · 02-14-2006, 03:21 PM

Part of my pre-operative work-up was a gallbladder ultrasound to determine if they gallbladder was okay, healthy, etc. It was fine and it is better to keep it if nothing is wrong; so I opted to leave it right where it is. Gallstones can be prevented with taking Actigall for a spell after surgery, I'll be taking that I think for 6 months.

I can understand the concern regarding the anesthesia. It is scary stuff for anyone, especially someone who has had problems in the past. I think ultimately that decision will be whichever you are most COMFORTABLE with. I do know that there is a lot of ability to do "double stitching" with open procedures and the remaining part of the stomach (the part you won't use again) is attached to the abdominal wall. With lap procedures, it is just left free in the area, moves off to a side and atrophies.

There is a much higher risk of hernia with open incisions, but a higher risk of leaks with lap.

Again, ultimately, it'll be whichever you and your doctor both feel is best for you! Leave that gallbladder where it is if its healthy and if you are worried about gall stones ask your surgeon about the Actigall.

Zenomia · 02-14-2006, 05:43 PM

A LAP Procedure takes special skills and additional training in order to be done safely and effectively. If your Surgeon doesn't have the specialized training in Laproscopic procedures specific to gastric bypass, then I would stick with the Open...or get a new Surgeon. My Surgeon here, has done the additional training on Lap equipment - as well as training on Lap for GBypass specifically...plus has over 500 Lap's under his belt. Here the Lap is a 2 hour procedure where the open is 4 hrs...

The choice most of the time is what your Surgeon is capable of, what he is TRAINED for, and if his success rate is higer with open, then I would go that route. If you do the research and think LAP is a better option for you, look for another DR!!!

I researched 5 facilites and 10 Surgeons before I found mine!! It's all about the skill of the Surgeon, the quality of the facility, and the educational level of the staff at the hospital or facility - in reguards to MO patients!! Most complications can be avoided or quickly treated with a highly trained staff in place!!

Just another perspective to ponder....