Laparoscopy is the approach of choice. Rarely the approach may change from laparoscopy to open during the procedure.
- Multiple previous open abdominal surgeries with significant adhesions.
- 2% of procedures started Laparoscopic end up being Open. This may be because of adhesions, large left side of liver, internal bleeding, internal injuries, unexpected findings, technical difficulty and others.
- Results of weight loss for open surgery patients is the same as the laparoscopic procedure because the procedure itself is exactly the same. The approach is the only difference.
- Complications related to the inside healing such as leaks, bleeding etc are the same as laparoscopic approach.
- Most significant difference is that the incidence of wound infection and hernia in the incision is about 15% – 20% with an open procedure. With laparoscopy both complications are reduced to less than 1%
The length of hospitalization, pain and recovery time are more with the open procedure.