Overview (LAPAROSCOPIC & OPEN Surgery)
The laparoscopic surgery was introduced in the early 1990s after the success of laparoscopic gallbladder removal. The studies till date have shown that the laparoscopic procedure has less pain and the patient can return to normal activities earlier when compared to the open surgery. The numerous benefits of laparoscopic surgery over the open surgery made us realize that the differences in both types of surgery are measured in days to weeks and not in months.
It is also important to consider that each person is different and so the perception of pain and occupation also differs. However, a patient who undergoes an open splenectomy will return back to work in a week while another patient undergoing the laparoscopic splenectomy will return back to work in six weeks.
What’s the best approach to surgery: LAPAROSCOPIC or open?
If you consider the actual operation performed during both the laparoscopic and open surgery is same, i.e. removal of the spleen. However, considering the time for recovery the laparoscopic surgery is the best approach to surgery. Patients undergoing the laparoscopic surgery have quicker recovery, shorter hospital stay and the cosmetic results are significantly better than the open surgery.
There is no difference in the complication rates between both the open and laparoscopic surgery. The rate of discovery of accessory spleens during both the approach is same. Some experts argue that the laparoscopic approach is better for identifying the accessory spleen due to the magnification presented during this surgery.
Not all patients can undergo a laparoscopic splenectomy because those who have very large spleen need to undergo treatment with an open surgery. The open surgery is quite difficult, has a greater risk for complications as well. Patients who have a normal-sized spleen are considered as a candidate for laparoscopic surgery unless they have other medical conditions like severe lung or heart disease that put them at risk. All in all, about 95% of the patients with normal size spleen will undergo the laparoscopic surgery.
Advantages and Disadvantages:
Open surgery requires a six to eight inch incision to open the abdomen for operation.
Laparoscopic surgery uses multiple smaller incisions, where the smaller instruments and camera called as a laparoscope is inserted through the incisions to perform the surgery.
This approach might require a three inch incision below the belly button.
Although the open surgeries are quite common, nowadays most surgeons prefer performing the laparoscopic surgery. Few surgeons choose the traditional preferred approach to perform surgeries due to some technical issues.
However, there are certain cases in which the laparoscopic procedure may become an open surgery due to unexpected complications. The weight loss and improvements in quality of life are equivalent between both the approaches for long-term results.
Laparoscopic surgery will have less post-operative pain. This approach also has a shorter hospital stay for patients. It has a faster recovery after surgery. This approach also has fewer wound complications like incisional hernias, wound infections and dehiscence. However, this approach also has high rates of bowel obstruction post surgery. It is not suitable for patients who already underwent abdominal surgery, in such a case open surgery will be preferred by the surgeon.
It is suggested to discuss with the surgeons about the pros and cons of each type of surgery before making a final decision. This will help your doctor determine the safe and uncomplicated surgery approach as per your medical conditions. Although laparoscopic surgery is the most preferred approach for surgery, but certain medical conditions might put you at greater risk. Hence, in such a case, the surgeon will prefer performing the open surgery to treat your medical condition.x
- Laparoscopic Surgery as given in “https://en.wikipedia.org/wiki/Laparoscopic_surgery”
- Journal of Endourology Hans Christian Jacobaeus: Inventor of Human Laparoscopy and Thoracoscopy