Open and Laparoscopic Approaches to Obesity Surgery
The open approach involves an 8 to 10 inch incision to open the abdomen and perform the surgery in open view of the surgical team. The laparoscopic approach creates five or six small incisions (1/4 or 1/2 inch long) instead of the one larger incision. In the laparoscopic method, a small fiberoptic tube (the laparoscope), connected to a video camera, is inserted through the small abdominal incisions. This gives the surgeon a magnified view of the patient's internal organs on a television screen next to the operating table. The entire operation is performed "inside" the abdomen, after gas has been used to expand it, with the instruments inserted through the various small incisions.
Advantages of Laparoscopy
Whatever the method used, the patient's average stay in the hospital is 2-3 days. When this procedure is done laparoscopically, patients recover faster and often return to work in 2 weeks (as compared to 4 -6 with traditional surgery). The rate of hernias (a complication in 10 to 20 percent of open procedures) is significantly reduced. Laparoscopic surgery also protects the patient's immune function, whereas open surgery can compromise the immune system and even promote the growth of any existing tumors.
Disadvantages of Laparoscopy
The laparoscopic approach often takes somewhat more operating time than the open approach. The amount of time the operation takes is not significant to the outcome of the surgery, but it can increase the risk of developing blood clots or wound infections. The longer time on the operating table may affect patients with severe apnea or heart disease and perhaps should be avoided by those patients.
In summary, the minimal access, laparoscopic surgical approach to the treatment of obesity may reduce postoperative pain and medication levels, promote faster return of bowel function, and improved cosmetic results. It is important to remember, however, that not all patients are candidates for laparoscopic surgery. Your surgeon will be able to provide you with the most appropriate treatment options for your individual situation.