Is laparoscopic surgery beneficial compared to laparotomy?

Laparoscopy or minimally invasive surgery is commonly known as ‘keyhole surgery’ and is beneficial in reducing the time the patient spends at the hospital in addition to other benefits like easy recovery and better wound healing.

What is laparoscopic surgery?

Laparoscopic surgery uses an instrument called a laparoscope, which is inserted to the patient’s body for the performance of the surgery. A laparoscope is a telescopic lens system and is connected to a video camera. The operative area of the patient’s body is visualized on a screen and the laparoscope is manipulated so to perform the surgery. There is also a fiber optic cable with a light source as well as a insufflator which is used to introduce carbon dioxide into the operative area. The light source is required, to help visualize the internal organs and the insufflation with carbon dioxide provides a work area so that there is no solid organ injury.

What are the common procedures done using a laparoscope?

With the advances in technology and modern medicine, almost all surgical procedures may be performed with the help of a laparoscope. The common laparoscopic procedures are cholecystectomy (removal of gall bladder), herniorraphy (repair of a hernia), surgery for GERD, splenectomy (removal of spleen), liver surgery, ulcer surgery, appendectomy (removal of appendix) and surgery for enteric perforation due to trauma.. But bariatric surgery (surgery for control of obesity) like lap band, gastric bypass surgery are also being performed under a laparoscope.

Is laparoscopic surgery beneficial?

A laparoscopic surgery is beneficial as compared to laparotomy ( a laparotomy involves opening of the abdominal cavity for the performance of the surgery). Some of the benefits of laparoscopic surgery are

1. The incision is very small. In case of laparotomy, the incision usually is midline or transverse and involves a lot of area on the abdomen. Where as, there are three or four small one or two centimeter incisions.
2. The blood loss during the surgery is minimal.
3. There is less amount of pain post operatively because of the smaller incision.
4. The recovery time is very less compared to laparotomy. After a laparoscopic surgery, the patient would be discharged from the hospital on the same day or the next day of surgery. The patient can resume his normal daily activities after two or three days, depending on the surgery performed. In a patient who had undergone laparotomy, the hospital stay would extend to atleast a week or two and would take more time till full recovery.
5. The chances of infection are very less when the procedure is laparoscopic.
6. The occurrence of complications is also minimal after a laparoscopic surgery.

Are there complications or risks of laparoscopic surgery?

As any surgical procedure, there is a chance of complications in laparoscopic surgery as well. Some of the complications that might occur are

1. Injury to a blood vessel or a solid organ in the abdomen. The insertion of the laparoscope is a blind procedure as visualization is possible only after the insertion. In case of an obese patient or a patient who has had some abdominal surgery before, there is a chance of injury to an organ within the abdomen. This may lead to perforation peritonitis and require further laparotomy and management.
2. Intolerance to pneumoperitoneum may occur. Some patients may not be able to tolerate the insufflation of the abdomen with carbon dioxide. The occurrence of this may change the course of the surgery and the procedure may be converted to an open surgery.

Since the chances of possibility of complications are minimal as compared to the benefits, many patients and surgeons prefer laparoscopy to laparotomy for the management of several surgical conditions.