Open or Laparoscopic Method? Choosing Which Roux-en-Y Surgery Suits You Best

Roux-en-Y gastric bypass or RYGB is currently the most common choice for bariatric procedure, according to the National Institutes for Health and American Society for Bariatric Surgery. In the US, 85% of all bariatric procedures employ the RYGB method. The authorities even call it “the gold standard for weight loss surgery having the best balance between weight loss and risk of complications.”

RYGB is done by stapling the upper part of the stomach to create a small pouch about the size of an egg and then attaching the small intestine to this pouch. This will bypass the rest of the stomach and reduce absorption of fat and calories.

Overall, RYGB delivers more positive results compared with other weight loss surgery procedures.

Laparoscopic vs. open surgery

While some people with obesity and serious health issues attempt to solve their problems the natural way, many believe in the advantages of bariatric surgery. Of course there are disadvantages, but doctors don’t fail to raise potential risks to their patients before conducting the operation. The decision also does not stop at determining the best surgical method.  It is also important to zero in on the most beneficial approach – open or laparoscopic surgery?

Today, laparoscopic seems to be the most favorable, but medical reviews suggest greater preference on the open surgery in contrast to what many would assume.

Open surgery

Open surgery is the traditional way of doing gastric bypass surgery, in which the doctor creates about 8-10 inches of incision on the abdomen, through which the surgeon will operate. Easy access on the area makes this method more comfortable than letting the surgeon wade his equipment through your organs, then cut and stitch your stomach only using a small camera and a monitor.

Surgeons know how to manipulate these things, of course, but the pressure and anxiety will always be present. Anyways, let’s look at the pros and cons:

Pros

• Procedure may take 1-2 hours depending on the doctor’s experience. Sometimes, it only takes 50 minutes for an experienced bariatric surgeon to carry it all out.
• Operating time is shorter. The surgeon can have a better look at the areas being operated on.
• Open surgery is less costly because surgeons use standard equipment. You will also be billed less because of the short operative time.

Cons

• Expect longer hospital stay (3-5 days in a hospital bed)
• Longer recovery time due to the size of the incision on the abdomen. For patients, daily routines normalize usually after 21 days of recovery.
• The bigger incision means an elevated risk of wound infection. During stay at the hospital, hospital staff attend to your needs but once you’re out, you’re on your own.
• Increased risk of complications

Laparoscopic

Patients are often attracted to the few beneficial points of open surgery, but most seem to love the idea of not being cut open. But laparoscopic method has its own share of pros and cons as well.

Pros

• Shorter hospital stay
• Shorter recovery period (patients can quickly go back to normal daily routine after about two weeks)
• Less risk of wound infection

Cons

• Higher risk of bowel obstruction
• More costly due to operating time (approximately $3000 more)
• The chances of having leaks from the sites of the incision are higher
• Higher risk of blood clot and internal bleeding

You decide. My advice is for you to be inquisitive enough to know what you will be going through. Weigh the pros and cons and opt for an approach that will bring you more peace of mind, reduce your chances of having revision surgery, or suitable to your lifestyle.

General benefits and risks of gastric bypass surgery

Open and laparoscopic have their respective pros and cons but bariatric surgeries in general share a common set of risks as well.

Pros

• Gives you higher chances of losing 60-75% of excess weight in two years
• Patients can gain back excess weight after about 10 years but only 10-15%
• Studies showed that 96% of associated health issues improved including diabetes, sleep apnea, and hypertension

Cons

• Higher risk of death and complications which may require a patient to undergo re-operation
• The procedure is reversible but complex
• Incompliant patient is not guaranteed to lose a significant amount of weight
• Regular intake of multivitamins and minerals is necessary due to mal-absorption of nutrients

The average excess weight loss after the Roux-en-Y procedure is generally higher in a compliant patient than with other restrictive procedures. You pick. My advice is to choose an approach that best suits your lifestyle. Work, family, and other commitments are factors that can greatly affect your decision-making, but it’s just the tip of the iceberg. Deciding whether to undergo gastric bypass surgery is still the toughest.