Surgeons utilize two distinct methods for diverse surgical interventions: laparoscopic and open surgery. It is important for preoperative patients to understand these treatment alternatives, including the surgical processes, benefits and drawbacks, and ensuing discomfort after operation. While clinicians are the ideal experts to determine the preferred surgical approach, patients’ comprehension of the two techniques enables meaningful treatment decisions. Laparoscopic or keyhole surgery involves a small abdominal incision of less than one centimeter. Through this opening, a laparoscope (a slender instrument equipped with a high-resolution camera) is introduced to enable visualization of the body’s internal structures without the need for open surgery. Surgeons then use a magnified view on a video monitor to perform the procedure. Various surgeries can be performed laparoscopically, including abdominal procedures to treat Crohn’s disease or inflammation of the colon, rectal prolapse (where а part of the rectum sticks out), chronic constipation, and duodenal perforation (holes in the intestine). Other surgeries that can be performed laparoscopically include gallbladder procedures, gynecological surgeries, and hernia surgeries to repair weak tissues in the abdomen. Laparoscopic surgeries are characterized by their minimally invasive nature, resulting in decreased pain, blood loss, and surgical trauma. The approach also reduces postoperative complications, promotes faster wound healing, and minimizes the duration of hospital stays. Less exposure to internal organs also reduces risks for external contaminants. That being said, trocar or instrument insertion, a key process in laparoscopic surgery, may lead to abdominal wall hematoma or bleeding, as well as umbilical hernia characterized by bulging tissue around the navel region. In some cases, doctors may recommend against laparoscopic surgery due to factors such as prior surgery in the area or excessive weight, which can impede surgical access and visibility. Emergency open access may be necessary in cases of significant bleeding or infection. Additionally, individuals with certain cardiopulmonary conditions may be at a higher risk of negative reactions to compounds like carbon dioxide used during laparoscopic procedures. Open surgery may be a safer alternative in these scenarios. Open surgery, a time-honored approach to surgical procedures, involves using a scalpel to make а large incision up to 10 inches in length on the skin to reach the intended surgical area. This technique provides surgeons with access to sizeable organs and facilitates the performance of intricate procedures like heart surgery, organ transplantation, and the elimination of kidney stones. Compared to laparoscopic surgery, open surgery is good for treating conditions like large tumors, complex fractures, and spinal tumors or severe scoliosis, which minimally invasive approaches cannot address. Open surgery also affords surgeons a clearer view of the operative site, facilitating more efficient tissue and organ manipulation. That being said, due to the need for extensive incisions, this type of surgery mаy cause increased post-operative discomfort, complications, and prolonged healing periods. Medical costs depend on several variables, such as the type of procedure, the patient’s medical history, and the health care facility. Typically, laparoscopic surgery incurs а higher cost due to additional equipment expenses. However, the quick recuperation and shorter hospital stay associated with laparoscopic surgery can offset costs. In the same vein, open surgery may seem cheaper at first glance, but а prolonged hospital stay and greater likelihood of complications may ultimately increase expenses. Patients should carefully weigh various factors when choosing between laparoscopy and open surgery. Consulting a medical professional is crucial to understand the nuances of one’s unique medical situation, rather than simply relying on personal judgment or non-expert opinions. A skilled surgeon will evaluate each patient before making recommendations, empowering them to make well-informed decisions.
Karim Sarhane, MD