Open vs Laparoscopic Surgery

Posted On : October 23, 2017

Written by Ara Keshishian, MD, FACS, FASMBS
Last updated: October 23, 2017

The differences between open vs. laparoscopic surgery are explained. Duodenal Switch can be performed open (traditional) or laparoscopic. Open surgery requires a 6 to 8 inch incision to open the abdomen for the operation and laparoscopic surgery uses multiple small incisions, and then a camera is used to view the abdomen while small instruments are used to perform the surgery through the incision points. The laparoscopic approach may also require a small 3 inch incision below the belly bottom for the hand port. This is so the small bowel can be measured for its entire length. Although open surgeries are still very common, many surgeons now perform the laparoscopic procedure. Some surgeons choose to perform their surgeries traditionally based on preference, and the anticipated technical issues that may be encountered, such as the revision cases from a gastric bypass to the duodenal switch operation. Keep in mind there are times when on the operating table, due to unexpected findings, complications or difficulties, a laparoscopic procedure may become an open surgery. Regardless of which way the abdominal cavity is entered weight loss and improvements in quality of life are equivalent between the approaches in terms of long term outcomes. [33-34] The laparoscopic approach is not suitable for all patients. Patients, who are extremely obese, have had previous abdominal surgery or have complicating medical conditions, may be required to have their surgery performed open.   Laparoscopic Advantages [23-28]

• Less postoperative pain
• Shorter hospital stay-even though this may not be significant (0.75 day shorter stay!)
• Faster postoperative recovery with comparable efficacy and less need for narcotics.
• Fewer wound complications (wound infections, dehiscence, incisional hernias)

  Laparoscopic Complications [29-32]

• Higher rates of postoperative bowel obstruction.

  The patient can discuss the pros and cons of each type of procedure with a number of surgeons before making a final decision.