Journal of Obesity & Weight Loss Therapy
Open Access

Laparoscopic Surgery; Obesity; Weight loss; Pulmonary embolism

Introduction

Understanding laparoscopic surgery

Laparoscopic surgery, also known as minimally invasive surgery or keyhole surgery, involves the use of small incisions and specialized surgical tools to perform procedures within the abdominal or pelvic cavities. Unlike traditional open surgery, which requires large incisions, laparoscopic surgery relies on the use of a laparoscope-a thin, flexible tube with a light and camera to guide the surgeon during the procedure [1,2].

Advantages of laparoscopic surgery

Reduced invasiveness: One of the primary advantages of laparoscopic surgery is its minimal invasiveness. The small incisions result in less tissue trauma, reduced scarring, and less post-operative pain compared to open surgery. This translates to faster recovery times, shorter hospital stays, and improved overall patient comfort.

Enhanced precision and visualization: The laparoscope provides surgeons with a high-definition, magnified view of the surgical site, enabling them to visualize intricate structures in great detail. This enhanced visualization enhances surgical precision, reducing the risk of damage to surrounding tissues.

Faster healing and reduced complications: Laparoscopic surgery minimizes the risk of complications such as infections and bleeding due to its reduced invasiveness. The smaller incisions also contribute to quicker wound healing, leading to a faster return to normal activities for patients.

Shorter hospital stays and reduced healthcare costs: Laparoscopic procedures typically require shorter hospital stays compared to traditional open surgery. This not only reduces the financial burden on patients but also allows hospitals to optimize bed utilization and allocate resources more efficiently.

Applications of laparoscopic surgery

Gallbladder removal: Laparoscopic cholecystectomy, the surgical removal of the gallbladder, is one of the most common applications of laparoscopic surgery. It offers a faster recovery, minimal scarring, and reduced pain compared to open surgery.

Hernia repair: Laparoscopic techniques are widely used for repairing various types of hernias, including inguinal, umbilical, and hiatal hernias. The minimally invasive approach allows for faster recovery, reduced post-operative pain, and lower recurrence rates.

Gynecological procedures: Laparoscopy is extensively employed in gynecology for procedures such as hysterectomy, myomectomy (fibroid removal) and treatment of endometriosis. These procedures offer women the advantages of smaller incisions, faster healing, and reduced pain compared to traditional open surgery.

Colorectal surgery: Laparoscopic techniques are increasingly used in colorectal surgery, including procedures like colectomy and rectal resection. Patients benefit from reduced post-operative pain, faster recovery, and improved cosmetic outcomes.

Bariatric surgery: Laparoscopic approaches are commonly used in weight loss surgery, including procedures such as gastric bypass and sleeve gastrectomy. These techniques result in smaller incisions, reduced scarring, and faster recovery for patients seeking long-term weight loss solutions.

Literature Review

Laparoscopic surgery has transformed the field of surgery, offering patients and surgeons numerous benefits over traditional open procedures [3-5]. The reduced invasiveness, enhanced precision, faster recovery times, and shorter hospital stays make it an attractive option for various surgical interventions. As technology continues to advance, laparoscopic surgery is expected to further evolve, ushering in

Reduced risk of infection: The smaller incisions in laparoscopic surgery decrease the risk of infection, as there is less exposure of internal organs to external contaminants. Lower blood loss and transfusion rates: Laparoscopic procedures typically involve minimal blood loss, reducing the need for blood transfusions during surgery. This is advantageous for patients with underlying medical conditions or those who may have a higher risk of complications from blood transfusions [6].

Disadvantages of laparoscopic surgery

Technical challenges: Laparoscopic surgery requires advanced training and expertise. Surgeons need to develop specific skills to manipulate the instruments effectively and navigate the surgical site using a video monitor. This learning curve can make laparoscopic procedures more challenging for some surgeons.

Equipment costs: Laparoscopic surgery requires specialized instruments, including the laparoscope, trocars, and surgical tools. The initial investment in equipment can be higher compared to traditional open surgery. However, over time, the benefits of faster recovery and shorter hospital stays may offset these costs.

Limited tactile feedback: Unlike open surgery, where surgeons can directly feel and manipulate tissues, laparoscopic surgery provides limited tactile feedback. This lack of tactile sensation can make it challenging to assess tissue characteristics, potentially leading to a higher risk of inadvertent injury.

Increased procedure time: Laparoscopic surgery can take longer than open surgery due to the complexity of the technique and the need for meticulous instrument manipulation. This extended procedure time may increase the patient's exposure to anesthesia and the overall time spent in the operating room.

Risk of complications: While laparoscopic surgery is generally considered safe, there is a small risk of complications associated with the procedure. These can include injury to blood vessels or organs, infection, bleeding, or adverse reactions to anesthesia. However, the overall incidence of complications is typically lower compared to open surgery.

Discussion

Laparoscopic surgery offers numerous advantages over traditional open surgery, including reduced invasiveness, enhanced visualization, faster recovery, and reduced risk of infection. However, it also presents some challenges, such as the need for specialized training, higher equipment costs, limited tactile feedback, increased procedure time, and a small risk of complications [6-8]. Despite these limitations, the benefits of laparoscopic surgery make it a valuable and widely used technique in modern surgical practice. Surgeons continue to refine their skills and technology continues to advance, further improving the outcomes and expanding the applications of laparoscopic surgery.

Laparoscopic surgery is generally considered safe and has a lower incidence of side effects compared to traditional open surgery [9,10].However, like any surgical procedure, there are potential side effects and complications that can occur. It's important to note that the occurrence of these side effects varies depending on factors such as the patient's overall health, the complexity of the surgery, and the surgeon's expertise [11-13]. Here are some potential side effects of laparoscopic surgery:

Pain and discomfort: After laparoscopic surgery, patients may experience pain and discomfort at the incision sites or in the abdomen. This pain is usually managed with medications and typically subsides within a few days or weeks.

Infection: Although the risk of infection is generally lower in laparoscopic surgery compared to open surgery, there is still a small possibility of developing an infection at the incision sites or in the abdominal cavity. Prompt medical attention and appropriate antibiotic treatment are necessary if an infection occurs.

Bleeding: Although laparoscopic surgery involves minimal blood loss, there is still a small risk of bleeding during the procedure. In rare cases, excessive bleeding may require additional intervention or even conversion to open surgery.

Organ or tissue damage: During laparoscopic surgery, there is a slight risk of accidental injury to nearby organs, blood vessels, or tissues. Surgeons take precautions to minimize these risks, but in some cases, additional surgical repair may be required.

Adverse reactions to anesthesia: Laparoscopic surgery is performed under general anesthesia, which carries a small risk of complications such as allergic reactions, respiratory problems, or adverse reactions to the anesthetic medications. Anesthesiologists closely monitor patients during the procedure to minimize these risks.

Blood clots: Prolonged immobility during laparoscopic surgery can increase the risk of developing blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism). Measures such as early ambulation, leg exercises and compression stockings are usually implemented to reduce this risk.

Shoulder or abdominal discomfort: Carbon dioxide gas is used to inflate the abdominal cavity during laparoscopic surgery, which can cause temporary shoulder pain or discomfort. This discomfort usually resolves on its own but can persist for a few days.

Scar tissue formation: In some cases, laparoscopic surgery may lead to the formation of scar tissue (adhesions) within the abdomen. Adhesions can cause pain, bowel obstruction, or fertility issues in rare cases. However, the risk of adhesion formation is generally lower with laparoscopic surgery compared to open surgery.

Conclusion

It's important to discuss any concerns or potential side effects with your surgeon before undergoing laparoscopic surgery. They can provide you with specific information based on your individual case and take necessary precautions to minimize the risks.

Acknowledgement

None

Conflict of Interest

None

1. Kelly ME, Fahy M, Bolger JC, Boland PA, Neary C, et al. (2022) Open versus laparoscopic liver resection of colorectal metastases: a meta-analysis of matched patient populations. Ir J Med Sci 191: 1531-1538.

Indexed at, Google Scholar, Crossref

2. Ran X, He X, Li Z (2022) Comparison of Laparoscopic and Open Surgery for Women With Early-Stage Epithelial Ovarian Cancer. Front Oncol 12:879889.

Indexed at, Google Scholar, Crossref

3. Laurence JM, Tran PD, Richardson AJ, Pleass HCC, Lam VWT (2012) Laparoscopic or open cholecystectomy in cirrhosis: a systematic review of outcomes and meta-analysis of randomized trials. HPB (Oxford) 14: 153-161.

Indexed at, Google Scholar, Crossref

4. Wang D, Dong T, Shao Y, Gu T, Xu Y, et al. (2019) Laparoscopy versus open appendectomy for elderly patients, a meta-analysis and systematic review. BMC Surg 19: 54.

Indexed at, Google Scholar, Crossref

5. Aziz O, Constantinides V, Tekkis PP, Athanasiou T, Purkayastha S, et al. (2006) Laparoscopic versus open surgery for rectal cancer: a meta-analysis. Ann Surg Oncol 13: 413-424.

Indexed at, Google Scholar, Crossref

6. Einarsson JI, Matteson KA, Schulkin J, Chavan NR, Haghpeykar HS, et al. (2010) Minimally invasive hysterectomies - a survey on attitudes and barriers among practicing gynecologists. J Minim Invasive Gynecol 17: 167-175.

Indexed at, Google Scholar, Crossref

7. Aarts JWM, Nieboer TE, Johnson N, Tavender E, Garry R, et al. (2015) Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 2015: CD003677.

Indexed at, Google Scholar, Crossref

8. Casadei R, Ingaldi C, Ricci C, Alberici L, Raffele ED, et al. (2021) Laparoscopic versus open distal pancreatectomy: a single centre propensity score matching analysis. Updates Surg 73: 1747-1755.

Indexed at, Google Scholar, Crossref

9. Biondi A, Stefano CD, Ferrara F, Bellia A, Vacante M, et al. (2016) Laparoscopic versus open appendectomy: a retrospective cohort study assessing outcomes and cost-effectiveness. World J Emerg Surg 11: 44.

Indexed at, Google Scholar, Crossref

10. Arezzo A, Vettoretto N, Famiglietti F, Verra M, Morino M, et al. (2013) Laparoscopy for rectal cancer reduces short-term mortality and morbidity: Results of a systematic review and meta-analysis. Surg Endosc 27: 1485-1502.

Indexed at, Google Scholar, Crossref

11. Zhang XL, Liu RF, Zhang D, Zhang YS, Wang T, et al. (2017) Laparoscopic versus open liver resection for colorectal liver metastases: A systematic review and meta-analysis of studies with propensity score-based analysis. Eur J Surg Oncol 44: 191-203.

Indexed at, Google Scholar, Crossref

12. Salminen P, Paajanen H, Rautio T, Nordström P, Aarnio M, et al. (2015) Antibiotic therapy vs appendectomy for treatment of uncomplicated acute appendicitis: The APPAC randomized clinical trial. JAMA 313: 2340-2348.

Indexed at, Google Scholar, Crossref

13. Vollmer CM, Lewis RS, Hall BL, Allendorf JD, Beane JD, et al. (2015) Establishing a quantitative benchmark for morbidity in pancreatoduodenectomy using ACS-NSQIP, the Accordion Severity Grading System, and the Postoperative Morbidity Index. Ann Surg 261: 527-536.

Indexed at, Google Scholar, Crossref