Weight Loss Surgery - Let's debate open rny vs. lap rny, please!

1 of our fat people
01-23-2003, 06:07 PM
Hey ladies!

Since my last post, I have talked to two actual real live human beings who had surgery with the new surgeon that I have made an appt with (the one that only does open). They both sing his very highest praises. However, the doctor has had one death... due to blood clot. Should I be concerned?

Also, I wanted to ask your opinions of the open procedure versus the lap procedure. On the one hand, I don't relish the pain associated with being cut from stern to bow, but also, I want the surgeon to be able to have a good look at what he's doing... so, what do ya'll think?


peach pit
01-23-2003, 07:48 PM

I think that if I had to do the open, that I would not do it. It gives me the heebie jeebies. When I had my tubes tied (thank you GOD) I only had one....or maybe two small little holes. I am sure that Jiff will come along with details of how it all works, but for the record, my obgyn was kind of old, and he could still see everything!!!!

But, with that said, if you are comfortable with the open, than that is what you should do.


01-24-2003, 10:49 AM
I am having it done Lap. At my consult in the group part, a lady asked about the painful gas that you get after a c-section, if we would have that with the Lap RNY and my dr. said that you may have some gas but not like with the open because the reason there is so much gas in a c-section and an open RNY is that once air gets to your internal organs they begin to bloat, so that is why there is so much gas after. You learn something new everyday!!!! Hazel

01-24-2003, 01:56 PM
OK, this is what a patient told me about open vs lap.

When it is open there is less chance of an intestine or the stomach getting a nick or scratch by the instruments moving around in the cavity. Each organ is taken out and examined to make sure there are no growths or anything “unexpected” the doctor can get a clear overview of what and where everything is, where in a lap procedure they are looking at one confined area at a time. If something goes wrong they are already there, no having to open up the patient.

Drawbacks to me.

Obviously an open wound. Healing time. (Though they keep you in the hospital longer, so I’m not sure if that is necessary all bad). Longer time off work, longer hospital time if you hate it there.

01-24-2003, 02:50 PM
I for one would have done open or lap. I wanted the lap for a number of reasons, but was willing to consider either form.

The first doctor I had an appt with only did open, found the doctor I used who did it lap.

I've heard all the arguments why one is better than the other. Lap folks say, less recovery time, smaller incisions. Open folks say, the doc can view better with open.

In my reading I have found that doc's who proclaim the open to be better are usually not trained in lap.

The argument of seeing better with open is still up for debate. I have read that doc's can see just as well with lap.

As for the death the surgeon had from a blood clot. This is a risky surgery, much safer than it used to be, but still anytime you have surgery you have risks. Wls is done on high risk patients, obesity and underlying health issues make us high risk patients.

The death rate is 1 in 200. You must do your research and make the decision that is right for you, only you can make that decision.

It's a tough one. On the one hand we have the risk of surgery, on the other hand, we have the risk of early death due to our obesity.

I must tell you, I thought about backing out. While I was recovering from all my complications, especially when the physical therapists were helping me to walk again, I cursed my decision to have the surgery. Now, I'm so thankful I went ahead with it. When I walk outside to take the pup for his potty time, I see my shadow and I can't believe it's me. It's a great feeling.

Sorry so long, I got started and didn't know when to stop.


01-24-2003, 04:27 PM
I had mine done LAP but had to sign a few forms that said I consented to conversion to open if needed so you really need to be prepared for either. Luckily mine was lap and stayed lap. I might have freaked out if I woke up and had had a conversion to open. I agreed to open as a possibility but because of the recuperation time, I really had a strong preference for lap.

01-24-2003, 04:34 PM
this is great!!! i don't even have to open my big mouth here!

i was happy with the lap, and knew it was the right choice for me, and believe me, my surgeon took a VERY good look around and even biopsied my liver. he's also been known to take out gall bladders at the same time. i really think that the argument for open that the doc can take everything out and actually look at it is specious. there's no reason for that whatsoever, and that also entails a risk.

i agree with deb that surgeons who only do open are simply not skilled in lap. and that's not so bad, but i wish they'd stop making excuses for their different skill set!!!!

1 of our fat people
01-24-2003, 06:31 PM
Thank you, thank you, thank you!

You guys said exactly what I wanted to hear... I knew I wanted lap, because, well... pain HURTS me!

I went to my PCP today and told her all about my bad experience with the B*tchy receptionist and the new doctor with the 80 surgeries and one death. Now, I trust my doctor explicitly. She is a young woman only about a year or so older than me. (So she's about 33) She is the doctor for my whole brood. She emphatically stood up for the lap procedure with the more experienced doctor. SOOO.. that leaves me back with the B*tchy receptionist.

Thats okay, really, because, if need be, I can... shall we say... get down on her level!

I feel like a ton has been lifted off my shoulders with this decision made!


peach pit
01-24-2003, 07:07 PM
Good Patty!!!!!! I am glad that you got the information that you needed!!! You sound relieved!

If you need back up in the B*tch department....you give a holler....we are quite good at it! :D

specious (adj) Seemingly attractive, true, plausable, or correct but actually not so.

yea, I had to look it up!


peach pit
01-29-2003, 07:47 PM
bump for Lorrie!

01-29-2003, 08:49 PM
believe it or not, i've been thinking about this for the past couple of days. deb and i live in major metropolitan areas with quite a few excellent surgeons in several directions. other folks aren't quite that lucky, and the choices of docs is more limited.

here's what's on my mind: lap was the best choice for me because i was so damned sick going in that NO ONE wanted to actually be terribly invasive and keep me under a second longer than was absolutely necessary.

if my choice was open or NO surgery, which i suspect is the choice some of you are facing, i would have chosen the open because the surgery was my last chance.

and about the office staff. yes. they are royal pains. yes, they can make your life difficult or a living HE:: but they will NOT do the surgery or the aftercare. it's most important to get a surgeon - lap or open - who has the most experience, insists on pre-op evaluations and counseling, who encourages you to talk to other people who have had the surgery, participates or refers you to an active support group for after surgery, and who requires 80 or more grams of protein and no carbs for your post-op diet.

and then you can rip into the staff, in face to face talks with the docs, letters to the docs, and letters to the insurance company.

does this help at all???? keep us all posted. this is a serious choice with serious issues...

1 of our fat people
01-29-2003, 09:27 PM
Thanks Jiff...

I plan to go to the surgeon who only does open on Tues, Feb 5(or 4th?). I have heard from so many of his patients that he is ABSOLUTELY wonderful. For some reason, in my heart, I want to go to him instead of the lap doctor who people are complaining about. You see, my brain would rather have a lap surgery. So, I am thinking that God has His hand guiding me to this other doctor. Thanks for your concern. And I will keep you posted!


02-06-2003, 10:21 PM
6Since Alvin has had both...long story for those of you who don't know it. I would say that either one is better than no surgery. Even if he had to do it over again Open, i think his answer would be "do it"

03-10-2003, 10:38 PM
I hope you all don't mind my jumping in here since I'm such a newbie, lol. First I'd like to say I'm one of the rare ones who had open and wanted open. My hubby had a lap surgery and almost died (not weight loss surgery by the way..it was a ruptured appendix and his insides were filled with nasties from the rupture) . The surgeon left something bleeding inside him and I felt like if he had opened my hubby up he'd have seen that bleeder and closed it off. That said my surgeon was one who did both lap and open. I told him my fears and he said that some surgeries you can actually see better lap then open and some you can't see better. He said gastric bypass is easier to see and perform open but he'd do which ever I wanted and that I didn't need to be afraid he'd open me up if he had any uncertainty. I still choose open but now later I feel my surgeon would have done just as well with the lap. The fear was in my mind. I'm not however sorry that I had my surgery and for me personally my scar is a small price to pay for how great I feel. If I were starting out now though and considering lap I'd make sure I had a surgeon who was very experienced with the lap procedure. I definitly wouldn't want to be the person the surgeon learns on though I know they have to start somewhere. Also those statistics on death rates and complications they very from surgeon to surgeon. I'd be finding out my surgeons personal numbers. I heard of a surgeon in New Jersey who had lost 1 out of over 1000 patients and I heard of a surgeon in Indiana who had lost 3 patients out of 56. Guarantee you the Indiana surgeon wouldn't touch me and I'd have let the New Jersey one due lap most likely, lol. It's just a personal decision and I think one where you really need to be cautious of your surgeons qualifications. Nuff said by me, lol. Carrie

1 of our fat people
03-11-2003, 08:02 AM
Thanks Carrie!

When was your surgery? How have you done?


03-11-2003, 06:58 PM
hey all! i just wanted to jump in here on a few points.

the surgeon that i am using also does both open and lap. we have discussed both options over and over and i am choosing the lap. he is one of the best doctors in this area and i trust his advise. i think it is basically your comfort level and what you truly want and feel safe with. both surgeries have been proven to be successful and both also have neagtive aspects. you just have to do what is right for you.

about evil office staff...i can very much speak on this repeatedly. the office staff at my doctor's office is absolutely awful! i have vented often about them. i am still right now waiting for a return call about the date of my surgery. i was supposed to receive this about a week ago. i called today and was informed that the lady i was dealing with is no longer with the office. (wonder why?) but, i was put in someone's voice mail and my call still was not returned. for those of you that know, i have such a horrid time with this office to even get my appeal sent in. what i did and what i know...i called and spoke to the office manager. my doctor's office is with one of the largest hospital networks around and i understand how busy they can be but still! i explained everything to her about the faxing and so on and she helped me right away. i would not hesitate to do it again here in a few days if i do not get called back.

also, what you may and may not know, each insurance company has a special department that handles member issues and complaints. (if you do not know, i work for a helath insurance company. yes i am the evil person youc all and yell at!!!) ours is called quality assurance. and all member issuess with quality of care are taken seriously and documented. what happens is that the person in the special department researches the issue, notifies the doctor's provider representative, and then notes the issue. the provider rep then in turns speaks and educates the doctor's office and also notes the issue. the issues are noted because if the doctor or the doctor's staff are repeat offenders, other things can happen above and beyond just your insurance company.

sorry so long! i just wanted to put all that out there.