Question:
Does anyone regret having open RNY instead of LAP?
My DR. talked me into doing Open vs Lap he said that the surgery takes less time so it's less risky. He said Lap patients have to stay in the hospital one extra day because the Lap doesn't lend itself as well as open because of the location of everything. He also said the scar amounts to the same except ones vertical the other is scattered. He's very experienced in both he does 30 rny a month. — Candace F. (posted on December 23, 2001)
December 23, 2001
I know that this isn\'t really an answer to your question but... I had Lap.
I am doing fine. I\'m 11 days\'s out and one of my steri strips just fell
off and one of my incisions is a tiny hairline. Already healed. As far as
the extra day in the hospital, it sounds like BS to me. I went in at
7:30am, they started at 8:00am, it was a two hour surgery and an hour in
recovery. I was in my room by 11:00am. I was walking by 12:30pm. I was
released the next day at 12pm. There was no extra day in the hospital.
From what I\'ve heard, open patients tend to stay in the hospital a tad bit
longer than lap patients. Hope this helps.
— tmrivas
December 23, 2001
Well, as for me, I voted for Open. I\'m a nurse, and I did not like the
idea of a doctor operating on my without visualizing what he is doing...I
mean, in front of his eyes. I know they can see what they\'re doing, but
it seems sensible to me. He could look at and feel my gall bladder to
evaluate it. I opted for Open, as well as my two sisters and we are not
sorry. Best wishes.
— Yvonne R.
December 23, 2001
I had no choice, but I can tell you that my open rny was easier physically
than I ever expected. I was in the hospital longer than I wanted to be (7
days), but that was my surgeons orders. I was in ICU 3 days (treated the
greatest). Happy to be home I stopped all pain meds 1 week post-op. I
consider myself blessed. He took out my apendix and gall bladder, does that
take away a few pounds off the scales (just kidding). I have a long scar,
but it blends in nice with the stretch marks so who cares, no bikini for me
EVER!Good luck with your surgery no matter how your Doctor makes your tool
for a new life.
— Angela S.
December 23, 2001
I had lap gallbladder surgery several years ago. I got a pocket of co2 gas
trapped in my shoulder and it hurt a lot for about a week. My back also
went out from the amount of time spent on the operating table. I was up and
walking the day of the surgery and home the next. I had open wls, went in
on mon morning came home Thurs afternoon. While my incision was a 4inch cut
down my tummy, I really didn\'t have much pain, and what pain I did have
the morphine took care of. Because I was only on the table for a little
over an hour, and because I was able to roll on my side the afternoon I had
surgery (something not all people can do because of pain or whatever) I
didn\'t have back problems. With both surgeries you still have to be
careful of lifting things because while the lap may be healed on the
outside, leading you to believe you are stronger than you are, the insides
still have to heal. Personally I trusted my dr and would have had either
one to get the surgery. There are advantages and disadvantages to both.
good luck
— Becky K.
December 23, 2001
Hello,
I have not yet had RYN, but I too had my gallbladder out with lap and you
DO NOT have to stay in the hospital an extra day. You actually get out
sooner. I as pregnant at the time so I was in for 3 day, but had I not been
pregnant, I would have been out the next day.
— Chelsea C.
December 23, 2001
Thanks for the responses. The reason I think they require you to stay an
extra day is because they can\'t test for leaks easily in a lap. I\'m
sticking with the open. I too had my gallbladder out lap bur they lost
stones they couldn\'t see because of it and I ended up jaundiced and in Icu
until they could get them out. So it was easy for them to convince me open
was better. I was just having second thoughts for a minute.
— Candace F.
December 23, 2001
I selected LAP because I didnt want another surgery. 30% of opens get a
incisional hernia and require a surgery to fix it. The chance of a
incisional LAP hernia is near zero. Around here opems hospital stay is
longer. Lap 2 days, open 4 days average. My wife is 14 days post op LAP
abnd her incisions are almoist totally invisible, just 2 are small red
marks.
— bob-haller
December 24, 2001
I had open simply because my surgeon does not DO lap. I really didn\'t
care either way, personally, though I know some definitely prefer lap. My
surgeon also told me that lap takes longer - twice as long, in her
estimation - and that the quicker they can get an obese patient off the
operating table, the better. There is a phenomena that can happen with
obese patients... anesthesia gets stored in \"pockets\" in the
body, and may not be released until the patient is in recovery and has been
given pain meds! IF the patient gets re-anesthetized with pain meds on
board - there can be real trouble! They can stop breathing, etc. My
surgeon DOES plan to possibly start doing lap surgery in the next year or
so - maybe - but ONLY on the healthiest of her patients... and the
smallest... and ONLY because there is such patient demand for it. Best of
luck to you in your decision! :)
— [Anonymous]
December 24, 2001
I had open, because I too wanted the surgeon to see what he is doing, and
be IN there if something happened. And besides I had the new procedure
called \"micropouch\", and the pouch is smaller than the lap
instruments, thus making lap impossible. My pouch will never stretch, and
never have to be revised. I will never have acid reflux either. I love
it, and it had to be done open.
— Phiddy B.
December 24, 2001
I had lap and there is no way I would have had open. I state that for
several reasons; the chance for incisional hernia (as someone mentioned
open is 30% risk). I was back to work much quicker. Many with open take 6
weeks off -- there is no way I wanted to be home for six weeks. I was back
at work -- and more imporatantly, getting back to all of my usual
activities (shopping, movies, hanging out with friends) -- in 10 days.
Also, I didn\'t want a big scar with a bunch of staples and a drain at
home. I had no stapes, no stitches and my drain was removed before I left
the hospital. My scars are so tiny and already fading and I am one month
pre-op.
Also the story about lap lasting twice as long is typically not true. It
only takes longer if the doctor is not adept with the tiny instruments. If
you have a dr that works with them all the time the length of surgery is
actually quite fast. I was on the table for two and half hours. That is
even less than some who have open. My doctor does all kinds of lap
surgeries (gall bladder, spleen, appendix) and thus, is very fast. If you
are trying to decide between lap and open don\'t just ASSUME it will take
longer. Ask the doctor what the average time is for sugery. It varies
greatly from doctor to doctor. This is very important as I read and again
and again that it is always longer. That simply is NOT true.
Frankly I think that lots of doctors tell their patients that open is
better simply because they do not perform lap and don\'t not want to lost
the business to someone who does. Think about it, what doctor is going to
tell you lap is better but I don\'t do it so go to a different doctor. Very
unlikely.
— Kirstin99
December 24, 2001
I think the least invasive procedure, the better. IF you have a surgeon
who is proficient in performing the lap procedure, than there is nothing to
worry about. Claims that you can \"see better\" with open are
unfounded. We just see it that way because we are not surgeons! It\'s
whatever the doc is proficient in. And you can magnify images with lap as
well.
I\'m going lap, but like everyone says they are pluses and minuses to
both.
Good luck!
— [Anonymous]
December 24, 2001
My surgeon performs both lap and open surgeries, but I opted for open
because he said that it is easier to see and it was less expensive. I
don\'t think that is \"unfounded\" according to him that it\'s
easier to see. He also stated that in some cases of other surgeons who
perform lap, that some people have to be opened up anyway, because of not
being able to see.
Anyway, patients of my surgeon can go back to work in 2-4 weeks after
having open. I had surgery on Dec. 10th and I\'ll be back in college
classes on Jan. 7th. I\'m at 2 weeks right now and I\'m feeling great. I
never had a feeding or drainage tube and I didn\'t have any staples. My
surgeon uses dermabond. It\'s like a human superglue. I don\'t think there
will hardly be a scar. It\'s clearing up so nicely.
I\'m not in any way putting down lap procedures, however. I do see the
benefits of it. I had my gall bladder removed through a lap procedure.
Perhaps it\'s just my surgeon, but he did an excellent job with the open
procedure.
— Jaimee S.
December 24, 2001
the choice was left up to me. I chose open , I was unconcerned about the
amount of scaring. I was very concerned about the amt of time I would be
under the anesthetic , I would spend less time with open. A former
boyfriend of mine is the chief of anesthiology at a large university
hospital, he told me we should be put under with the least amt of meds for
the shortest time possible. For me , at my age and with my medical history,
open was the correct choice for me. You must make your own evaluation. I
never regretted my decision.
— Rose A.
December 24, 2001
It seems like \"Anon\" gets around. My surgeon does specifically
say that it\'s easier to see open vs. lap. I chose open.
— Tieia
December 24, 2001
I did not have a choice becuase I had previous abdominal surgery - I had
the open surgery and am glad. I wanted the doc to see everything and to be
under for as short a period of time as possible. I had no problems
whatsoever.
— Lisa B.
December 25, 2001
I didn\'t have a choice between open vs. lap because my surgeon only does
the open procedure. He has studied the lap procedure and does\'t feel
comfortable with it. I trust his judgement 100% and am happy with my
decision. If you trust your doctor and he recomends open and you don\'t
have a problem with the scar I suggest you go with that. I do want to tell
you about my experience with lap gallbladder surgery 9 years ago. I had one
of the leading surgeons in my city with tons of experiece doing lap
gallbladders. I didn\'t have a problem during surgery but 5 days later
passed a gallstone that was left behind in one of the ducts. This was a
very frightening experience right after surgery (I even called 911 and the
paramedics found me curled in a ball on the floor the pain was so bad). If
the surgery had been open the doctor would have been able to feel that
stone, but couldn\'t visualize it on the x-ray because of the postion of
the picture and he couldn\'t see it through the laproscope either. Based on
this one experience I prefer open surgery.
— georgiacarol
December 26, 2001
As with everything in life, the post op courses of open or lap will vary
with each individual. Nothing should be given as absolute fact. I had open
surgery 1/8/01 and my recovery was extremely uncomplicated and easy.
However, there are many lap patients that recover much slower. I was really
not given a choice of procedures. I will only occasionally regret my open
\"scar\", which is actually fading rapidly. My surgeon uses skin
glue and no staples, so my scar is a pencil thin line that only 2 people
see! I would love to see the documented proof of the 30% figure for
hernias. I am sure the rate is higher for open (obviously), but that
percentage seems high to me. Could the increased rate be due to the hanging
apron pulling on the incision? Those with the largest aprons would not have
been candidates for the lap, so therefore would have to have had open? I
think we can use statistics to say whatever we want. But, we need all of
the facts. I have had no problems and my surgeon feels that my risk for
hernia is now close to 0. However, I answered this question to say what I
have noticed to be a \"trend\" with the post ops on this board.
This is extremely unscientific and only my personal observation. It seems
that those patients that have leaks, surgical complications, or post op
complications tend to be lap procedures. Whenever I read about someone with
a complication, I click on their profile and the vast majority are lap. I
am certain these risks depend on the expertise of the surgeon. This
\"opinion\" is given only to encourage thorough research of your
surgeon (open as well as lap!). Shelley
— Shelley.
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