Laparoscopic bariatric procedures

What is laparoscopy?

Laparoscopic surgery is often referred to as minimally invasive surgery. Laparoscopy utilizes small (1/2 inch or smaller) incisions instead of the large incision used in traditional open surgical procedures. Through the small incisions trocars (pen shaped tubes with a valve) are inserted into the abdominal cavity, which is inflated with carbon dioxide gas to create space between the internal organs and allow visualization and organ manipulation. One of the trocars is used to allow access for the video camera, whic also has a built-in light source.

Today, most modern laparoscopic systems provide high definition image quality and the surgeon and the team view the procedure on a separate video monitor. These systems provide outstanding visualization and access to anatomical structures that are otherwise only accessible via large incisions that may extend to the back or the chest.

The surgical instruments are inserted through the additional trocars. The laparoscopic instruments are desined to fit through the thin trocars yet provide similar efficacy to their traditional counterparts. This approach is considered less invasive because it replaces the need for one long incision to open the abdomen.

The revolution of laparoscopic surgery started in the late 1980s and the first report of a laparoscopic gastric bypass was published in 1994. Since the mid 1990s an exponential rise of weight loss surgeries was experienced and today over 90% of all weight loss surgeries are done laparoscopically.

Traditional incision	Laparoscopic incisions

Several studies have demonstrated that this technique is is not only safe, but provides better pain control, faster recovery, and much improved cosmetic outcomes. Through the improved pain control, other postoperative problems, such as pneumonia, deep venous thrombosis and pulmonaru embolus occur much less frequently. Incisional complications, such as wound infection and hernia formation in the incisions following laparoscopic surgery is almost non existent.

Laparoscopic procedures for weight loss surgery employ the same principles as their "open" counterparts and produce similar excess weight loss. Not all patients are candidates for this approach, just as all bariatric surgeons are not trained in the advanced techniques required to perform this less invasive method.