Keyhole vs Open for bypass

[WeightlossWannabee]

Does anyone know whether keyhole is considered to be less risky than open surgery for a bypass - do complications arise with one type of surgery more than the other, or is there no difference
Thanks

 

[marky v]

my doctor is doing mine in the 'open' style, he likes to do it this way because he feels it's safer, less problems with leakage at the new joints etc, but the other doctor who could've done my surgery at the Nuffield in Leeds, would've done it by key-hole, i think alot of it is down to the doctor's preferences, but from what i gather they are as good as each other, i believe the recuperation time for open surgery is slightly longer for obvious reasons, hope that covers it

 

[Snowcrystal]

Yes I beleive the recovery can be a lot longer with the open surgery.

The downside too is the scar I would think.

(((hugs)))

 

[WeightlossWannabee]

Yes I beleive the recovery can be a lot longer with the open surgery.

The downside too is the scar I would think.

(((hugs)))

Thanks SC.
Any ideas about complications?

 

[thinkbethin]

Open surgery means a longer recovery period than key hole. Some surgeons prefer open and some prefer keyhole. I've never known a band being done by open surgery but I have know bypass's being done open so I guess it depends on which op you're having and what the surgeons preference is.

 

[marky v]

i think if there were to be complications, i reckon they'd be rather similar, the main one for both is the actual bypass bit i guess, where the lower part of the intestine is connected to the new pouch, and the part of the intestine connected to the now defunct lower part of the stomach is re attached further down, the main thing i see here is possible leakage from the stitching, but i must say i guess this is very rare, one other thing i thought about, would be with open surgery, you'd have more of a risk of a hernia as the wound is obviously larger through the abdomen wall, but after all major surgery, we mustn't over do it

 

[Snowcrystal]

Thanks SC.
Any ideas about complications?

I don't think the complications arrises because of the type of operation...(just my opinion).

I would think that if there were complications that arise outside of the type of operation it would be quicker for the surgeon to act...(again just my opinion)

Some surgeons have not been trained to do laparoscopy.

(((hugs)))

 

[candie]

My surgeon told me the healing process is quicker and easier with keyhole ops; and having had the bypass keyhole, and another op open, I can see what he meansI have been up and about much quicker this time, as my cuts are minimal

 

[phatgirl]

As per the BOSPA site:

Open or laparoscopic surgery

Laparoscopic surgery is a minimally invasive approach to surgery and your surgeon will have undertaken additional training to be able to operate this way. Several small incisions (1/2 – 1 inch long) are made in the abdominal wall, through which are inserted tubes that allow the passage of the surgical instruments needed for the operation. The positioning, number and size of these incisions might vary from surgeon to surgeon. A small camera is inserted into the abdomen, and the surgeon operates by watching his activities on a video monitor. This provides better visualisation and better access to important anatomical structures. To enhance his vision, your abdomen in inflated with gas, and as much as possible of this is expelled again at the end of the operation. However you may feel a bit bloated, or have “wind” pains under your diaphragm or in your shoulder tip for a few days whilst any final gas bubbles are slowly reabsorbed. Compared to open surgery, benefits of laparoscopic surgery include

• Less post-operative pain
• Better cosmetic results
• Fewer wound infections
• Fewer incisional hernias
• Faster recovery and return to pre-surgical levels of activity

HTH,
Nic

 

[WeightlossWannabee]

As per the BOSPA site:

Open or laparoscopic surgery

Laparoscopic surgery is a minimally invasive approach to surgery and your surgeon will have undertaken additional training to be able to operate this way. Several small incisions (1/2 – 1 inch long) are made in the abdominal wall, through which are inserted tubes that allow the passage of the surgical instruments needed for the operation. The positioning, number and size of these incisions might vary from surgeon to surgeon. A small camera is inserted into the abdomen, and the surgeon operates by watching his activities on a video monitor. This provides better visualisation and better access to important anatomical structures. To enhance his vision, your abdomen in inflated with gas, and as much as possible of this is expelled again at the end of the operation. However you may feel a bit bloated, or have “wind” pains under your diaphragm or in your shoulder tip for a few days whilst any final gas bubbles are slowly reabsorbed. Compared to open surgery, benefits of laparoscopic surgery include

• Less post-operative pain
• Better cosmetic results
• Fewer wound infections
• Fewer incisional hernias
• Faster recovery and return to pre-surgical levels of activity

HTH,
Nic

Thanks, Nic

One post-op complication I've become aware of is bowel perforation.
Do you know if this is more likely with one type of surgery than the other?
Thanks x

 

[WeightlossWannabee]

my doctor is doing mine in the 'open' style, he likes to do it this way because he feels it's safer, less problems with leakage at the new joints etc, but the other doctor who could've done my surgery at the Nuffield in Leeds, would've done it by key-hole, i think alot of it is down to the doctor's preferences, but from what i gather they are as good as each other, i believe the recuperation time for open surgery is slightly longer for obvious reasons, hope that covers it

Thanks, Mark.
Do you know why some surgeons use staples, and other stitch???

 

[kell]

Not sure about complications but I had open and the scar is very unsightly. Nearly 4 weeks post op and its still not healed Also I was warned about a risk of getting a hernia. x

 

[WeightlossWannabee]

Not sure about complications but I had open and the scar is very unsightly. Nearly 4 weeks post op and its still not healed Also I was warned about a risk of getting a hernia. x

Thanks,Kell.
Is is normal for the scar not to have healed after 4 weeks

 

[kell]

lol...I dunno, I hope so! lol

Most of it is healed, just an angry red colour, but theres about 3 little bits that refuse to heal, just keep scabbing over. It was very sore after staples came out so maybe that had something to do with it? x

 

[Silversurfer]

Thanks, Mark.
Do you know why some surgeons use staples, and other stitch???

Theres only one surgeon i know of that stitches internally - Basil Ammori - apparently its very technical and i was told by my consultant that surgeons comes from the US to watch this procedure as its very uncommon. I spoke with Mr Ammori about this before my op with him and he said that stitching leaves much cleaner joins and less surgical adhesion (scar tissue) which cant be avoided with staples, plus he said it makes his work more interesting

 

[WeightlossWannabee]

Theres only one surgeon i know of that stitches internally - Basil Ammori - apparently its very technical and i was told by my consultant that surgeons comes from the US to watch this procedure as its very uncommon. I spoke with Mr Ammori about this before my op with him and he said that stitching leaves much cleaner joins and less surgical adhesion (scar tissue) which cant be avoided with staples, plus he said it makes his work more interesting

Thanks, Rich.
I thought stitching was more commonplace than that.x

 

[phatgirl]

Thanks, Nic

One post-op complication I've become aware of is bowel perforation.
Do you know if this is more likely with one type of surgery than the other?
Thanks x

Bowel perforation is possible with either procedure and the risk is increased/decreased not by procedure but by the experience level of the surgeon. The learning curve for surgeons is estimated at 100 procedures so if your surgeon has performed 100+ wls you have a lowered chance of bowel perforation.

 

[switcher]

My RNY bypass was carried out by Miss Heitmann at Walsall Manor as an open op. I am not yet 4 weeks post op, my scar is about 6" long but is now totally healed over. I wasn't given the option of it being open or keyhole but maybe that's because I'm a bloke who is obviously not going to be as sensitive to the scar that's left. It wasn't stitched either, the wound was glued (on the outside anyway, maybe there were stitches inside though).

From a recovery point of view I am really happy with my progress and what I feel able to do. I'm even getting on the exercise bike to give the surgery a helping hand.

 

[xxsarahxx]

My RNY bypass was carried out by Miss Heitmann at Walsall Manor as an open op. I am not yet 4 weeks post op, my scar is about 6" long but is now totally healed over. I wasn't given the option of it being open or keyhole but maybe that's because I'm a bloke who is obviously not going to be as sensitive to the scar that's left. It wasn't stitched either, the wound was glued (on the outside anyway, maybe there were stitches inside though).

From a recovery point of view I am really happy with my progress and what I feel able to do. I'm even getting on the exercise bike to give the surgery a helping hand.

good for you, sounds like your well on your way to that new physique lol. you caught my attention as i'm from willenhall and hoping to get approved for an op at walsall manor. where did your funding come from? i've heard walsall have no funding for wls? all these questions i have lol x

 

[switcher]

good for you, sounds like your well on your way to that new physique lol. you caught my attention as i'm from willenhall and hoping to get approved for an op at walsall manor. where did your funding come from? i've heard walsall have no funding for wls? all these questions i have lol x

Thanks for your kind words. I intend to use the surgery as a tool to get me to my goal weight rather than expect the surgery to do it all for me.

The funding came from BEN PCT, my initial referral from my GP in Great Barr.