LAP vs Open

[Guest guest]

Hello everyone-

My name is A.V. Vickers and I have been observing your interactions

for awhile. I'm finally getting up the nerve to post. I was

interested in some opinions on the LAP procedures vs Open with a

surgeon who normally specializes in open but is venturing into LAP

procedure. Previous lap procedures done =1, he said this surgery was

6 hours, and that the patient is recovering well. Other patients

have posted that they consulted about the lap procedure and he was

open to performing the procedure. I don't know what to do, I want

the surgery, and am willing to do open if that will increase the

likelihood of a successful recovery. But if I can have the lap for

obvious benefical reasons should I attempt it? I usually recover

pretty well from surgeries and about 27 y/o with sleep apnea as a co-

morbidity. Do you think six hours is excessively long?

[Guest guest]

> I applaud the honesty of your surgeon. Who is it? You have

> to decide whether you want to be in the " learning curve "

> of your surgeon. This is a procedure that really tests the

> limts of lap use. I would also ask the surgeon what other

> procedures and how many he has done lap. What is his

> experience as a lap surgeon in general?

I totally agree, Dawn. I was Dr. Rabkin/Jossart's 2nd fully lap DS, and

I knew that my anesthesia time might be longer because of it. I was

under for over five hours. But I went in feeling confident because I

knew that Rabkin's lap experience was extensive, and was very confident

in his ability and in his choice of Dr. Jossart as an assistant.

Rabkin's lap DS time has come way down now, and his complication rate is

very low. But he is a meticulous and skillful surgeon who doesn't

compromise the procedure in any way, optin for the hand assist in order

to do the procedure in the manner that he had done is open since 1993.

If you're confident in your surgeon's experience and skill, and really

want the lap procedure, but are aware of the possible ramifications of

being so early in the series (longer OR time, possible conversion to

open, slightly higher leak risk), then I say go for it and best wishes

to you! On the other hand, if you are hesitant about it, I'd certainly

not be talked into lap just to please the surgeon.

M.

---

in Valrico, FL, age 39

Lap DGB/DS by Dr. Rabkin 10/19/99

Starting weight 299, now 155

Starting BMI 49.7, now 25.8

Starting size 26/28, now 10/12

http://www.duodenalswitch.com/Patients/_M_/melanie_m_.html

Direct replies: mailto:melanie@...

_________________________________________________________

[Guest guest]

Dear A.V.,

I had full Lap BPD/DS and my surgery lasted less than 3 hours.

Jane J.

Do you think six hours is excessively long?