What is Laparoscopic Surgery?
In traditional open surgery, a large incision is made on the abdominal wall in order to gain access to the abdominal organs. In contrast, laparoscopic surgery is performed through several very small incisions.
A laparoscope, or surgical telescope, is inserted through one of these incisions so that the entire surgical team can see the internal organs displayed on a color TV monitor. Narrow instruments, also 1/4" to 1/2" in diameter, are inserted through other small incisions to cut, staple, clip and sew. Using very sophisticated instruments, advanced laparoscopic surgeons can perform almost any abdominal operation through the laparoscopic approach.
Laparoscopic surgery has a number of advantages over open surgery:
Faster Recovery: Because the incisions are much smaller, patients are able to return to work and normal activities much more quickly than after open surgery.
Less Pain: Smaller incisions hurt less than large incisions.
Fewer Incision-Related Problems: A small incision is less likely than a larger incision to become infected or develop a hernia. This is particularly true with bariatric surgery patients, since the abdominal wall is thicker.
Open (or "traditional") surgery is performed through a large incision, allowing the surgeon to directly access the abdominal organs. This is the method that has been used for hundreds of years.
The advantage of open surgery is that it allows the surgeon's hands to enter the abdomen. Thus, the surgeon can easily access the abdominal organs and examine them by touch. There are still some surgeons who only use open surgical techniques.
The obvious downside of open surgery is that it requires a large incision. This is more painful and requires more recovery time than the laparoscopic approach.
What is Revisional Bariatric Surgery?
While bariatric surgery provides excellent result for most patients, some patients -- particularly those who may have had an outmoded operation performed many years ago -- may not have had the positive outcome they expected. If you have had a bariatric operation in the past, but have not achieved successful weight loss, you may be a candidate for a revisional operation.
Patients who underwent "stomach stapling" (vertical banded gastroplasty, or VBG) and are left with inadequate weight loss may be a candidate for a later gastric bypass or a BPD procedure.
It is important to understand that any revisional procedure is a very major operation, with risks that are greater than for a primary procedure.