Laproscopic Versus Open Bariatric Surgery

Laparoscopic surgery is a technique in which the surgery is done utilizing several small incisions (one inch or less). A telescope with a television camera is used to direct the surgeons who use instruments passed through sleeves. This approach offers several advantages including less postoperative pain and associated complications such as pneumonia, more rapid healing, quicker return to work and a lower incidence of wound complications. As the result of these benefits the laparoscopic approach is used in most patients who undergo bariatric surgery. In some cases, however, the laparoscopic approach is not appropriate and may be associated with a higher incidence of complications. Your surgeon will advise you as to which approach would be best in your case. Examples where the open technique should be used include patients with the most severe obesity. In these cases, the laparoscopic technology does not allow adequate exposure or facility to get the surgery accomplished.

Patients with large abdominal wall hernias, multiple prior operations with known adhesions or scar tissue also necessitate open or standard incision surgery. In any case in which the laparoscopic approach is elected, it may be necessary to convert to an open incision. This may occur if the laparoscopic image is insufficient to safely complete the procedure, or if bleeding or other problems are encountered which would best be resolved by open incision.

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