WEIGHT LOSS SURGERY at The Institute for Laparoscopic Surgery







Laparoscopic surgery uses small incisions and a camera to perform the exact same operation that requires a large incision in open surgery. All weight loss operations can be done laparoscopically or open. 

 

In our experience, there are very few patients who should not be considered for a laparoscopic approach for their weight loss surgery.

 

Studies have shown that there are proven advantages for the patient undergoing a laparoscopic gastric bypass compared to an open gastric bypass in terms of:

 

  1. lower risk of wound infections and hernia
  2. better heart, lung and immune function after surgery
  3. less pain after surgery 
  4. faster return to normal activity
  5. no increase in the risk of serious complications like intestinal leaks or pulmonary embolus when done by an experienced laparoscopic surgeon

 

Many surgeons with extensive experience in open gastric bypass but limited laparoscopic experience continue to recommend open surgery instead of laparoscopic surgery. In our experience, many surgeons recommend the best operation they can do for their patients, but not the best operation which can be done for their patients.

 

In general, laparoscopic surgery has been shown to result in less pain, faster return to normal activity, and better cosmetic results compared to open surgery. The vast majority of abdominal operations can be performed with laparoscopic techniques by an experienced laparoscopic surgeon. The following questions about laparoscopy in general are answered below:

 

  • What is laparoscopic surgery?
  • What are the advantages of laparoscopic surgery?
  • What are the disadvantages of laparoscopic surgery?  
  • Why do some surgeons still recommend open surgery?     
  • What is "hand-assisted" laparoscopic surgery?
  • Why come to the Institute for Laparoscopic Surgery?       

 

Q. WHAT IS LAPAROSCOPIC SURGERY?

A. Although we call laparoscopic surgery "minimally invasive surgery", the difference between traditional open surgery and laparoscopic surgery is simply the size of the incisions we use to perform the surgery. Laparoscopic surgery has been shown to result in less post-operative pain, decreased need for narcotics, shorter hospital stay, faster return to normal activity, and better post-operative body image compared to traditional open surgery. Laparoscopic surgery can be performed for the majority of abdominal operations.

 

In open surgery the surgeon makes a long incision on the patient's abdomen, sometimes from just below the breast bone to just above the pubic bone. Metal retractors are then used to spread the abdominal wall, allowing the surgeon to see inside and perform the surgery. The long incision and forceful retraction of the abdominal wall result in the majority of post-operative pain.

 

In  laparoscopic surgery the surgeon makes several small incisions measuring 1 centimeter (about inch) or less. Carbon dioxide gas is placed in the abdomen to lift the abdominal wall away with minimal trauma. A camera is placed through one of the incisions and projects a picture of the inside of the patient's abdomen onto a TV monitor in the operating room. The surgeon can see inside the abdomen and operate through the other small incisions. If  the operation is too difficult to complete laparoscopically due to inflammation or adhesions, the surgeon switches to open surgery. This is called a conversion.

 

Q. WHAT ARE THE ADVANTAGES OF LAPAROSCOPIC SURGERY?

A. Laparoscopic surgery results in less post-operative pain, decreased need for pain medicines, shorter hospital stay, faster return to normal activity, and better post-operative body image compared to traditional open surgery.

 

Q. WHY DO SOME SURGEONS STILL RECOMMEND OPEN SURGERY?

A. Many qualified surgeon with years of experience in open surgery but limited laparoscopic experience fail to recommend, or even mention the option of a laparoscopic approach despite the evidence of better outcomes with laparoscopic surgery. Surgeons who either can't or don't want to learn the laparoscopic techniques may recommend open surgery over laparoscopic surgery.

 

Q. WHAT ARE THE DISADVANTAGES OF LAPAROSCOPIC SURGERY?

A. The major disadvantage of laparoscopic surgery is the "learning curve" which refers to a surgeon's early experience with laparoscopic surgery when the possibility of complications or conversions is higher, and the time it takes to perform an operation is longer. If your surgeon has limited experience and training in laparoscopic techniques, you are more likely to have complications or require conversion to open surgery. 

 

Q. WHAT IS "HAND-ASSISTED" LAPAROSCOPIC SURGERY?

A. Hand-assisted laparoscopic surgery involves making an incision large enough for the surgeons hand and wrist to be placed in the abdomen. Many surgeons with limited laparoscopic experience feel that hand-assisted laparoscopic surgery maintains the benefits of laparoscopic surgery, but is easier to learn. "Pure" laparoscopic surgery is generally better compared to hand-assisted laparoscopic surgery.

 

Q. WHY COME TO THE INSTITUTE FOR LAPAROSCOPIC SURGERY?

A. The Institute for Laparoscopic Surgery is committed to providing superior quality and service in minimally invasive surgery to our patients. At the Institute for Laparoscopic Surgery, we have specialized print and audiovisual patient education material available, including videotapes of specific operations for your review. All procedures are performed by experienced surgeons with a special interest in laparoscopic surgery  who are board-certified in their specialty. Our operating room team is comprised of  dedicated medical professionals with a special interest in laparoscopic and minimally invasive surgery. Our conversion rates from laparoscopic to open procedures are as low or lower than rates reported in the surgical literature. We are equally comfortable performing laparoscopic or open surgery. You are more likely to be offered a laparoscopic option and more likely to have a successful laparoscopic operation.

 

 

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