Bariatric surgery has been performed for decades. For most of those years, surgeons performed bariatric surgery using an open technique, which required a long incision and traditional medical instruments. The disadvantage to open surgery is increased incisional pain, leading to a prolonged post-operative recovery and increased complication rates.
As medical technology evolved, the laparoscopic or minimally invasive technique was introduced and widely adopted. Using the minimally invasive technique, a surgeon performs the same operation, but creates several ¼ to ½ inch incisions and uses long-handled instruments. This technique is associated with faster recovery, less pain, and less scarring.
Both approaches have similar success rates in reducing excess weight and improving or resolving co-morbid conditions.
The newest advance in laparoscopic surgery is Single Incision Laparoscopic Surgery, also known as SILS. With SILS, procedures such as the gastric banding can be performed via one incision in the belly button, which is hidden. The result is surgery without any visible scars. Currently, we perform SILS gastric banding for carefully selected patients. We will discuss this option with you during your initial consultation.
Considerations
Not all patients are candidates for the laparoscopic approach, just as not all bariatric surgeons are trained to perform this less-invasive method.
In some patients, the laparoscopic, or minimally invasive, technique cannot be used. Here are reasons why you may have an open procedure, or that may lead your surgeon to switch from laparoscopic to open:
- Prior abdominal surgery that has caused dense scar tissue
- Inability to see organs
- Bleeding problems during the procedure
The American Society for Metabolic and Bariatric Surgery recommends that laparoscopic bariatric surgery should be performed only by surgeons who are experienced in both laparoscopic and open bariatric procedures.