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Join Date: Nov 2005 Location: Tokyo, Japan
Posts: 23,801
5' 5"
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Welcome to the board, thank you for joining us.
Do a lot of search and research to find the right procedure for you, and the right surgeon for you.
((((((HUGS)))))) May your journey go well.
Open RNY. Well, for one, a lot of those who are pretty long out have had open due to the fact that lap was still in the baby stages, or weren't being done altogether. Another reason someone had open would be, something turned up during the surgery, so the surgeon had to switch to open to complete the surgery. There also are surgeons who will go open because you are too big for lap--with lap, the view the surgeon can get is very much limited comparing to having full view when open, so, in cases of very very obese people, the surgeon may have no choice but to go open, going in lap would be too dangerous. Where the surgeon sets the limit will differ with each surgeon and his/her experience and expertise, but I think the threshold is somewhere around BMI 55-60. I think it used to be around BMI 50, but these days, I do hear of more surgeons doing lap with patients in the low 50s.
The surgeon you went to may do only open because he/she had a bad experience in the past with lap, or it may simply be that he/she is not trained in lap due to 1) received training long befor lap became the more prevalent method (which incidentally, from what I have been reading, seems to be within the past 5 years at most) and hasn't had the chance yet to retrain for lap, or 2) simply didn't train for lap surgery at all--which can happen, because training to be a surgeon means first to become proficient in open surgery, then train for lap surgery, as with all lap surgeries, the surgeon has to be prepared to go open if the necessity arises--so all lap surgeons have to be trained with open as well, and this is going to take more time than training just for open surgery. I don't know the deets of the surgical residency in the US, but probably, while the present program enables one to train both for open and lap, in the past, when lap surgery was still in the developing stages, the standard training program would have included only open, and these surgeons would have had to go back and retrain for lap at a later date when lap surgery became more prevalent.
Actually, open surgery is not necessarily dangerous, but it does take more recovery time, and lap surgery requires more expertise because of the limited view. (If you ever had the chance to see what an open abdomen looks like and what it looks like with a lap view, then I think you'll know what I mean.) So, with a surgeon who does only open, it may be that he/she isn't keeping up with, and taking the time to retrain for, the newest procedures, but some people, I will have to admit, are more, um, well, clumsy than others, so while they are excellent surgeons when doing open, the surgeons themselves may not feel comfortable with only the closed in view from the laparoscope.
Anyway, it is most important to have the surgery done by the surgeon you feel comfortable with, and have good rapport with, as basically, you will have to keep in touch with him/her for the rest of your life.
Now, who had open? CraigT who hosts this site did, but as he marked his 10 year anniversary this May, so his reason is, lap was still very much in the baby stage, and only a few surgeons were actually doing it. mike also, I think he said his surgeon did only open and he was cool with it.
Hope this helps.
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who had open r-n-y? question? 
So long as you are putting your best foot forward, then, 
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