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Health Answers

Is laparoscopic surgery always better?

Q. Is laparoscopic surgery always better?

A. Laparoscopic surgery, also referred to as minimally invasive surgery, is an alternative to traditional open surgery in the abdominal and pelvic cavities. Instead of one large incision, the procedure uses very short incisions, through which tubular instruments called trochars are inserted. Carbon dioxide gas is pumped in to inflate the cavity and allow surgeons to see and maneuver in the space. Other trochars are used to insert a special camera called a laparascope and to insert and manipulate narrow surgical instruments. Some laparoscopic procedures may rely on robotically controlled devices.

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Julie Kim, chief of bariatric surgery at Tufts Medical Center, says that laparoscopic surgery offers several advantages. Patients recover faster and experience less pain during their recovery. The smaller incisions also create a lower chance of complications such as infected wounds and hernias.

Kim says that surgeons may opt for an open procedure if the patient has a health risk — if their bodies can’t withstand the pressure of gas in the abdomen for instance. And surgeons occasionally opt for an open incision during a procedure. “We don’t want people to think converting to open surgery is a complication in itself or is something that’s bad,” she says.

Laparoscopic surgeries require special instruments, training, and skills, and surgeons have debated whether certain procedures benefit from the access and maneuverability of an open incision. Ongoing studies are evaluating the costs, risks, and benefits of the technique for specific procedures, and patients should discuss these advantages and disadvantages with their surgeon.

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