Lap vs. Open

  • I'm gathering from most of your posts that you feel the lap method is the best. My surgeon doesn't do the lap, as he feels more comfortable about leaking, infection, etc. with the open. He told me the recovery time is about the same and that the incision is only about 6 inches long. Does that sound reasonable?

    What do you folks think?

    Lorrie
  • Hi Lorrie!

    I am going to pull up a thread for you that discusses this topic!

    hope it helps!

    peach
  • Thanks, Peach. I read what everyone had to say and appreciate the input. I'm kind of torn, tho. I live in a rural area, however, I'm within 1.5 hour drive of some very good hospitals (Chicago area). My problem is the WISH program does not have an insurance affiliattion, which means I have to go out of network, which means it's going to cost bookoo bucks.

    The Dr. I found is closer to my home (45 min) and is in network. I hope I'm not sacrificing convenience for competency. This surgeon is very skilled at other lap procedures, but he told me the lap surgery actually takes longer by about an hour, and the hospital stay is longer by about a day. Does that make sense to anyone?
  • not at all. the rny takes about 2 hours. and, if no complications, you spend a total of two nights in the hospital. open takes about 3-4 nights of hospital time. is this surgeon saying that open takes an hour> i find that real hard to believe, BUT ...

    one surgeon in northern new jersey who refuses to even learn lap brags that he can do 8 opens in a day. who wants to be on that kind of assembly line? and every patient i've met who's gone to him is ANGRY. and i'm not sure why. although i have heard that he provides absolutely no support, no dietary or nutritional guidance, and has made no effort to get support for his patients in the hospital he uses.

    not that your doc is like that, and there are lap surgeons who fit that description as well...

    key issue: a competent surgeon who believes in support and lots of protein.

    keep investigating. you have to come to a decision and a path that suits YOU.
  • Thanks. The surgeon says the procedure takes longer with the lap because he would have to move more slowly, can't actually touch the organs, etc. He also said he requires a longer hospital stay with the lap to make sure there is no leaking or problems. He said he does lots of leak tests with the open before closing to make sure everything is up to par.

    I've spoken to several of his patients and they seem to be happy with him. He's performed about 150 procedures (3 per week) so far and has had 2 complications at the hospital - both of which were leaks.

    I'm going to continue my studies, anxiously waiting for insurance approval and will take it from there.
    Lorrie
  • I'm thinking that this surgeon is not very skilled in laproscopic surgeries and is making excuses.

    I'm not sure why, but how would it take longer to monitor leaks because of lap rather than open...once your tummy is closed it's closed...seems rather odd.

    Every surgeon I have read, talked to, etc. has said Lap is less invasive, recovery and hospital time is significantly less, etc.

    Not to knock the Open RNY, but I'm rather confused at the doctor who makes these claims. If he prefers Open, then fine, but if he's making excuses and claims that aren't truly founded about Lap Procedure, that would send up a red flag in my opinion.
  • i'm with you, amy. i wish he'd just admit that he's not comfortable with the lap and move on!!!! not knowing how to do the lap doesn't make him a bad surgeon, just one who doesn't do the lap!!! from what lorrie is saying, he's been doing this a little more than a year [150 surgeries divided by 3 per week, and allowing some vacation time].

    so the next question is about the support and aftercare...

    my surgeon tested for leaks before he closed me up. no problem!!!!!
  • QUICK~
    Somebody call Peach quick! Our very own jiff left herself WIDE OPEN for a huge sisterly dig - right here on this very thread!!!!!

    Oh, peach, I just can't wait for you!! I might have to say it myself. But then what if Jiff takes it the wrong way - though it was meant in jest. It's just that sisters are allowed to say these things and then wait for the next opportunity to score again.

    Peach - Peach - where are you????

  • Hello girls!

    I will just jump in here with a quote that I found in Barbara Thompson's book Finding the Thin Person Hiding Inside You (which I think was recommended by Debbie).

    On page 57
    "Laparoscopic surgery usually takes approximately 90 to 120 minutes as opposed to 60 - 90 minutes for the open procedure."

    So... your doctor is correct when he says that the lap procedure takes longer.

    Now, I myself have debated this very point. I think I will opt for open rny, because the doctor I prefer does it only, and because I have had three c-sections that have caused lots of adhesions on my colon.

    If you are happy with your doctor, I don't think it matters too much how you get there... the end result will be the same. You just might have a bigger "Franken-belly" with an open procedure.
    (And I am SURE you are as concerned as I am with the scarring ! LOL)

    Patty
  • oh prazn.. go for it!!!! you can do it!!!!!
  • Prazn, I now crown you an honorary sister!!!!!!

    go for it!!!!!! YOU CAN DO IT!

    I'll be right behind ya! (trust me!)

    promise!

    peach
  • SHHHHHHHHHHOOOOOOOOWEEEEEEe
    .... Thank you! Whew, I was holding my breath for over 24 hours! But that is probably good because I got to exercise my lungs for surgery next week.

    So here it is the retort - to my new friend jiffy --- whom I have dubbed the 'GET REAL GIRL' ....

    'so the next question is about the support and aftercare...

    my surgeon tested for leaks before he closed me up. no problem!!!!!...

    but did he test the right place for leaks?? You seem to ooze advice and wisdom all over the place - AND nobody could ever close you up ' NO problem!'

    (Peach - how did I do?)

    Leanna
  • you did great!!!!!!

    see....that wasn't so hard was it? and guess what? YOU COULD DO IT AGAIN!!!!!

    although, for the record, our other sister (yes, there are 3 of us) is the REAL get REAL girl....I refer to her as "notjiff" Notjiff is the one that will knock you upside the head when you need a reality check....she is the best....honest...she is THAT GOOD!

    But it is always nice to have another sister around....it's an estrogen thing!

    again, prazn....YA DONE GOOD!!!!!

    peach


  • that was a good one leanna!!!! and before the surgery, i had so much trouble breathing that i couldn't talk! and soon after, when the weight started falling off, peachie would look at me and say things like:

    "i used to be able to get a word in edgewise"

    and

    "it used to be so much quieter around here!"

    is OOZING better than SPOUTING OFF???? hmmmmmm