RNY question - why do some have lap and others have open? - ThinnerTimes

IpsieDixie · 03-13-2006, 06:50 PM

Hi Y'All,

In my support group, some of the pre-ops are scheduled for lap RNY and the rest will be having open. Since the recovery time and pain are less with lap, why doesn't everybody have it? What are the reaons for doing open instead?

Dixie

feliciadragon · 03-13-2006, 07:17 PM

I'm not sure why anyone would choose to have open versus lap, but one of the reasons that can force you to have open is if you have too much scar tissue from previous surgeries. I had already had two laproscopic procedures - one to remove my gall bladder and one to remove an ovarian cyst, so the doctor told me that we would start of with the lap and if there were complications or a lot of scar tissue, he might have to do open instead. He did have some complications which caused the surgery to go a lot longer than originally anticipated, but was able to finish with the lap and not actually cut me open, thank goodness.

Stacieeg · 03-13-2006, 07:54 PM

I chose to have open surgery. I dont know why exactaly but I think I just felt better having open. Recovery wasn't that bad for me I heal very fast and was up doing all that I needed to do in no time.

Mavisavis · 03-13-2006, 07:59 PM

The place I went based it on the BMI and whether you had old scar tissue. I thnk 50 or higher BMI they did open. I believe their reasoning is that lap requires a a longer sedation and they don't like the risk to the patient due to the extra anesthesia.

twokids · 03-13-2006, 08:02 PM

My surgeon preferred to do the open proceedure vs. lap. Cost was also a factor. It was going to cost more for me to have lap, (something about surgical room time)

I think it is important to discuss your situation with your surgeon and decide which proceedure would work best for you.

Vertigo · 03-13-2006, 08:22 PM

Cost, time of surgery, risk of surgery, time of recovery, scars, and trusting my doctor -- who is one of the best bariatric surgeons in the country.

In and out of the hospital in 24 hours? C'mon...I was home watching The Price is Right the next day. How sweet is that?

ready4achange · 03-14-2006, 05:43 AM

My surgeon bases it on BMI. Since I had a big BMI he did it open. Guess its easier for them .
Sandy

Dyann · 03-14-2006, 07:16 AM

The most important factor is surgeon experience. You should chose what they do with the lowest complication rates. In experienced hands, laparoscopic is better if your size and previous surgeries allow it to be technically performed. Otherwise, if your surgeon does open and you have no other options, you have it open.

cnvh · 03-14-2006, 07:47 AM

I am starting the process of pursuing WLS (going to the hospital's info session on Thursday, woohoo), and in reading over the hospital's literature and website, it states that they do the lap procedure for people whose BMI's are between 40-50. This is quite disappointing to me, since I had thought I would be a good candidate for lap-- I have never had any abdominal surgeries before and thus no scar tissue, and I'm still pretty young (30) and aside from my weight, am in pretty good health. BUT my BMI is about 57. The thought crossed my mind to pester for an exception, but upon further consideration, I think I'd be better off letting a surgeon do whichever method he/she thinks is more appropriate!

JJ Girl · 03-14-2006, 07:49 AM

My surgeon is young and grew up playing video games so his hand, eye coordination and his ability to be comfortable looking at a screen to do his surgery is easy for him. Some of the older surgeons are not as well adapted to laproscope procedures.