Question:
~~~Does Lap. or Open have a higher mortality rate.?

~~~I was wondering if there is a higher mortality rate in one or the other..... I know there are different complications that can go wrong, and the leackages and so on, but is there a higher rate amongst one of them. Thank you for taking the time to answer. ~ Nicole    — Nicole W. (posted on March 16, 2003)

March 16, 2003
My surgeon performs Open & Lap, but, prefers Open. He said there are more things that can go wrong with Lap, and also that when performing Lap, the pouches cannot be made as small as they can when performing Open. Also, the have only been performing Laps for a shorter period of time and do not know the long term results yet. He will perform lap if insisted upon though.
   — jarrett318

March 17, 2003
I think a better question to ask your surgeon would be: <p> <i><b>Which do YOU have a higher mortality rate with, lap or open?</b></i> <p> Since I believe the more relevant information is the surgeon's record. Many complications that go wrong are due to surgical error and incidents that happen during surgery. Be an informed consumer and do your homework! Good luck to you.
   — thumpiez

March 17, 2003
I'm with the other posters when I say that I don't know of any statistics on open vs. lap. I think the most important thing is what your surgeon is most comfortable with. The few people on this site who had reported on the surgeon I used had all had open. When I went for my consult, he said he could do it lap. I didn't even question it. I would have been better off if he had done it open, since it had to be re-done open 2 months after the lap procedure. I believe he is very experienced in other lap surgeries, but not so much in the RNY procedure.<p>Also want to mention that I do have diabetes, type 1 so I will always have to take insulin, but I healed quite well after both surgeries. The key is keeping the diabetes in control. I insisted on having an endocrinologist follow me during all of my hospital stays.
   — garw

March 17, 2003
I'm pre-op, but at consultation, my surgeon said that he does open because it's less time on the table under anesthesia. Open is usually 1.5 hours or so, while Lap can be up to 5 hours or so and both can vary widely depending on surgeon and patient. He also said that the longer you are under anesthesia, the longer you are in the recovery room. One of the biggest risks with this and any other surgery is blood clots. The quicker you are off the table and up walking, the better off you are. With Open, you can be up and walking in 4 hours or so, with Lap, it's going to be closer to 10+ hours. If you are really sure you want it Lap, I agree with the previous poster who said to ask your surgeon what his mortality and/or complication rate is for both open and lap. Good Luck
   — Carolyn M.

March 17, 2003
Well, clearly, all surgeons are going to tell us different things. My personal belief? There is NO DIFFERENCE in the surgery, only a difference in the skill levels amongst doctors. My surgeon rarely (if ever) does open, and my lap took less than two hours. There is NOT a difference between lap and open in terms of leakages...if you are transsected, you aren't going to have a problem regardless of how you got there. Do your research, please...and don't just believe everything you read here. And....good luck!
   — Tamara K.

March 17, 2003
Jen my wifes LAP table time was 1.5 hours with a BMI of over 60. So short table time isnt just a matter of lap vs open. I took over 2 hours thanks to adhesions from my old appendix removal, the scar was huge. I have ofetn wondered if LAP less cutting leads to a more and faster mobile patient helping them to heal faster and reduce the chance of blood clots?LAP does reduce to near zero the chance of a incisional hernia. I understand surgeons debate this SAME question oin a regular basis.
   — bob-haller

March 17, 2003
Jen my wifes LAP table time was 1.5 hours with a BMI of over 60. So short table time isnt just a matter of lap vs open. I took over 2 hours thanks to adhesions from my old appendix removal, the scar was huge. I have ofetn wondered if LAP less cutting leads to a more and faster mobile patient helping them to heal faster and reduce the chance of blood clots?LAP does reduce to near zero the chance of a incisional hernia. I understand surgeons debate this SAME question oin a regular basis.
   — bob-haller

March 17, 2003
I doubt that there are any real statistics on this. My lap surgery took 1 hour and 10 minutes! I was up on my feet within 6-8 hours of going under and I know a number of people who had open who were not out of bed until the next day for their leak test. I think the most important thing is the skill of the surgeon and that you are as healthy as possible going into surgery.
   — Carol S.

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