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What if laparoscopic will not work?



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My mind is running crazy with all these questions now that I am getting close. What happens if the Surgeon starts the procedure laparoscopically but has trouble performing the surgery, does he stop or does he open you up and do major surgery? Does it depend on the surgeon? What would cause the surgeon to not be able to do it laparoscopically? Has this happened to anyone here on the forum?

Thank you.

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What is your BMI? From what I have read, most of the time when they are not able to do it laproscopically is if you have an extremely high BMI. That is one reason some people are required to lose weight before the doc will do the surgery. It is also one of the reasons you have to do a liver shrinking diet prior to surgery. If you follow your pre-op diet you should not have a problem. Hopefully someone who had that complication will respond to your question. From reading on here, it is a very rare issue. One however that I think we all worry about before surgery.

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What is your BMI? From what I have read, most of the time when they are not able to do it laproscopically is if you have an extremely high BMI. That is one reason some people are required to lose weight before the doc will do the surgery. It is also one of the reasons you have to do a liver shrinking diet prior to surgery. If you follow your pre-op diet you should not have a problem. Hopefully someone who had that complication will respond to your question. From reading on here, it is a very rare issue. One however that I think we all worry about before surgery.

Thank you. My BMI is 41. I will follow the pre-op diet to a T. I would not go through this and not follow the surgeons instructions, i want to try and eliminate any possible problems.The thing that i have read that is confusing, some surgeons have their patients on a 4 day, 10 day, 2 week or longer pre op liquid diet, why so much variance?

Thanks again.

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My BMI was 43 and the surgeon said he had no problem at all. Things looked great. It sounds like you are going into it with the right attitude. The varying pre-op diets is just the surgeon's personal preference. They have not been doing this surgery really long enough to have a consistent standard of care for the pre-op diets. They are doing studies. Any of the options they use provide positive benefits. The pre-op diet has a couple of purposes. First it is to shrink your liver, which gives the surgeon more room to do the procedure with the laparoscope. I think most docs use a 2 week pre-op diet. Some however do either none or just a couple of days. Some even though they do a 2 week one do full liquids, some do some variation of a low carb diet. My surgeon used basically a modified low carb diet. I did Protein shakes for Breakfast and lunch with a piece of fruit and another shake mid-afternoon and a low carb dinner. All the studies I read said this would shrink the liver just as well as a full liquid diet, they also show that usually a 1 week diet worked just as well as 2 weeks. Docs also tend to recommend diets based on where they were trained and what diets that doctor or facility used. The pre-op diet also jump starts your weight loss and reducing your BMI even a little bit helps to give the surgeon more room to maneuver.

Good luck with everything. It sounds like you will do fine, just follow your docs advice. Keep us updated on how things go.

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You usually would sign something pre-surgery stating what you allow. If you are ok with it....if the surgeon CANNOT do the surgery lapro then he would convert to an open surgery - but they usually only do that with pre-consent. If you haven't consented...they stop the surgery at that point (I have read of this happening).

However - and this is very rare but does happen - if there is a complication (uncontrolled bleeding for instance) they may have to quickly convert and try to save your life.

Reasons that they may have to open include: large fatty liver, adhesions or scar tissue, emergencies..etc.

Hope this helps.

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I weighed 385 with a bmi of 60 and was 62 years old. Syrgery went fine. No problems. However there is always a risk when having surgery. Unlikely they would have to open you up though. Btw I also worried about thatvwhen I had gall bladder surgery a few years ago snd my excellent and very experienced surgeon told me he had done X (a lot!- hundreds- an older guy) GB surgeries and could count on one hand the number of times he had to open someone up since it started being done laproscopically.

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I weighed 385 with a bmi of 60 and was 62 years old. Surgery went fine. No problems. However there is always a risk when having surgery. Unlikely they would have to open you up though. Btw I also worried about that when I had gall bladder surgery a few years ago and my excellent and very experienced surgeon told me he had done X (a lot!- hundreds- an older guy) GB surgeries and could count on one hand the number of times he had to open someone up since it started being done laproscopically. I think the risk of open surgery is very low but again there is always that risk no mayyer what your bmi or age.

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I had a lower BMI, but have had several prior abdominal surgeries. They were slightly worried about scarring. My surgeon was pretty sure he could do it laproscopically, but he had me sign the consent for open surgery also just in case. He was able to do the procedure laproscopically with no problem. I was on a 5 day liquid pre-op diet.

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My Dr. too was concerned about possible scar tissue due to 2 previous surgeries. I had to sign a form to possibly open for the surgery but all went fine. Good luck you will do fine!

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Sometimes they are unable to reach the stomach through the esophagus - that is another reason to do opoen surgery. I signed permission but my doctor told me at my pre-op appt Wednesday that he has never had to convert to an open surgery in nine years of doing sleeves. I was reassured!

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Sometimes they are unable to reach the stomach through the esophagus - that is another reason to do opoen surgery. I signed permission but my doctor told me at my pre-op appt Wednesday that he has never had to convert to an open surgery in nine years of doing sleeves. I was reassured!

Through the esophagus? I'm confused....why would they need to go through that? I've watched a bunch of surgeries on Youtube and never once seen them do anything to the esophagus.

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Hi :D I have not been sleeved yet, but....I have had 16 abdominal surgeries, some laporoscopic, and most open. From what my surgeons have told me in the past, it all depends on the liver. If u have a fatty liver, and they have a hard time getting in, they may need to do it open. Some surgeons will tell u b4 hand that if the liver is not as required, they may have to do it open. My surgeon for the sleeve says I dont need a pre op diet. I will be open anyway, cause im having 4 hernia repairs and more, at the same time, but I know for sure....that pre-op diet does help shrink the size of the liver to make it easier for them. Good luck to u. :D

What is your BMI? From what I have read, most of the time when they are not able to do it laproscopically is if you have an extremely high BMI. That is one reason some people are required to lose weight before the doc will do the surgery. It is also one of the reasons you have to do a liver shrinking diet prior to surgery. If you follow your pre-op diet you should not have a problem. Hopefully someone who had that complication will respond to your question. From reading on here, it is a very rare issue. One however that I think we all worry about before surgery.

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I was concerned about that also. I had my gall bladder removed the 'old fashioned' way, back in 1977. My doc was concerned about that also, but said that he would do everything he could to perform it laparascopicaly. Thankfully, he didn't have to open me up. YEA!!!! It's my understanding that if they do have to do it open, the incision is only about 2 inches. My BMI was 53.9.

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Regardless of if the surgery is laprascopic or open it is still MAJOR SURGERY don't delude yourself thinking that the exterior incision changes anything.

My mind is running crazy with all these questions now that I am getting close. What happens if the Surgeon starts the procedure laparoscopically but has trouble performing the surgery, does he stop or does he open you up and do major surgery? Does it depend on the surgeon? What would cause the surgeon to not be able to do it laparoscopically? Has this happened to anyone here on the forum?

Thank you.

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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