Question:
How big is too big for lap surgery?

I am trying to get lap RNY. My BMI is 52.6. I weigh 336 lbs. and am 5'7". Most of my weight is in my belly and thighs. I have heard that my surgeon tells people who are 50 lbs. less than me and WAY below me in BMI to watch their weight now and not get any bigger because they are boarderline for lap surgery. I haven't talked to my surgeon yet. (still waiting) I would be more than willing to diet before surgery if needed, but then I'm afraid they will say "oh, you are doing fine with diet and exercise. You don't need surgery". Any ideas? Where is the dividing line (in regards to BMI) between lap and open surgery usually?    — [Anonymous] (posted on February 14, 2002)

February 14, 2002
My doctor told me that he is comfortable doing lap on anybody under 365, as long as they are not extremely short. I hope this helps. Good luck.
   — Kathryn L.

February 14, 2002
Dr. Mark Kligman stated that a good guide for lap is lay on a exam table or floor at home, put your hands and arms up over your head and have someone try to feel your ribs. If they can feel your ribs, your in luck. If not, you will most likely have to go open.
   — MICHAEL Z.

February 14, 2002
I was scheduled for a lap RNY on 11/29/01, my beginning weight was 364, and I'm 5'4". My Surgeon told me that it depended upon where you carried your weight, and because I carried most of mine in my thighs and lower abdomen, he said he would proceed with the lap. However, during surgery he had to convert to open, as my spleen was too close to my stomach. I'm only telling you this so you are prepared for either situation, not to scare you. I am 100% happy with my decision to go through with it, and wouldn't change a thing for the world! I had a great Surgeon whom I was glad didn't take any chances.
   — Chloe S.

February 14, 2002
I'm 5'4 tall and now around 330, but when I saw the surgeon for the first time, I was around 350. He said he felt that he could do a lap on me even at my weight. I'm told he pretty much does everyone lap, although if there is a problem, he will do an open. I think it depends on the experience of the surgeon and what they feel comfortable with.
   — Sue F.

February 14, 2002
It's not just your weight that plays a factor. I was 5'5 and weighed 260 lbs. and was scheduled to have my procedure done Lap but when they went in my liver was too big. I was disappointed that they had to do it Open but I'm down 80 pounds in 5 months so I'm not too disappointed :)
   — Nicolette O.

February 14, 2002
I am 5'7, started at 269. I was expecting a lap, but woke up with an open... I was disappointed at first, but I am pretty much over it. I'm not getting sick, and I think that's more important than the bigger scar. Your surgeon knows what is best for you, listen to his/her advice.
   — Angela B.

February 14, 2002
I was afraid that I was way too big for Lap, but my surgeon said that she WOULD do the Lap on me. I'm 5'6" and at the time, was 408. I'm still pre-op but down about 20lbs. It depends on the skills of your surgeon, how you carry your weight and your BMI--all together! Good Luck, you're considered a lightweight!
   — jenn2002

February 14, 2002
Another factor is the ORs equiptement. It depends on the specific tools they have. Higher BMIs require longer and more expensive equiptement.
   — bob-haller

February 15, 2002
Our surgeon has performed lap WLS on patients up to 600 lbs. However, he is one of the pioneers in laparascopic WLS and has performed over 900 cases. There are several factors that may influence a surgeon's ability to perform a procedure laparascopically, and most surgeons routinely explain to their patients that even though the goal is a lap surgery, they may indeed wake up with a larger incision than expected. Also, in order to successfully operate on larger patients, the hospital (or the surgeon) must provide longer laparascopes to accomodate the greater depth of the abdomen....ask your surgeon if the appropriate equipment is available to him/her. The bottom line probably still lies in the experience and expertise of the surgeon. Good luck!
   — Diana T.

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