Laparoscopic vs Open Bariatric Surgery

Open weight loss surgery involves the use of traditional surgical methods, often requiring abdominal incisions of up to ten inches, while laparoscopic surgery is minimally invasive using the “keyhole” method to access the abdomen.

During laparoscopic obesity surgery, a laparoscope with a tiny camera is inserted into the body through a small incision. Other surgical instruments are inserted in up to 4 additional ports in the abdomen. Each incision is only about ½” wide and the instruments are guided into the abdomen using trocars or passageways through the abdomen. Our surgeons use a computer monitor to view the inside of the body while performing the surgery. In order to get the best view, the abdomen is inflated prior to surgery using carbon dioxide.

Benefits of Laparoscopic Bariatric Surgery

In addition to reduced scarring, laparoscopic procedures also have the following benefits:

• Reduced hospital stay following surgery
• Quicker recovery time
• Less post-operative pain
• Reduced risk of hernias. Larger incisions increase the change of developing an incisional hernia, because the abdominal wall is weakened at the incision site.
• Reduced risk of infections

Candidates for Laparoscopic Surgery

At our practice, the vast majority of bariatric surgeries are performed as a laparoscopic procedure. Most of the patients we see are candidates for the minimally invasive approach, however a consultation is needed to determine the best course of action.

When Open Surgery is Necessary

Your safety is our primary concern, and there are times when open surgery may be better for some patients including:

• Those with extremely high BMIs, as abdominal fat may prevent us from accessing or seeing the entire surgical field
• Those who have significant scar tissue (possibly from another abdominal surgery) that precludes us from accessing or viewing the surgical field
• Those with certain health conditions that make laparoscopic obesity surgery risky

In rare cases, the procedure will be converted from laparoscopic to open during surgery, if circumstances warrant. This is typically only done for patient safety or procedure effectiveness reasons.

During your consultation, you will be advised by your surgeon as to your suitability for laparoscopic surgery. We encourage you to ask us any questions you may have about the difference between open and laparoscopic surgery during this consult.

A Note on Robotically Assisted Bariatric Surgery

Robotic technology has taken minimally invasive surgery to the next level. Qualified patients may benefit from the dexterity of the robotic arms used to assist us in surgery.  Because the instruments used in robotic surgery have “wrists,” much like the human anatomy, we are able to perform more complicated cases in a minimally invasive manner. These would have otherwise been performed with a large single incision. Traditional laparoscopic techniques continue to be used for a majority of our cases, however when warranted, robotic surgery can be a good option. Learn more about robotic surgery.