Disadvantages: Laparoscopic Bariatric Surgery

With the benefits of modern technology, the practice of bariatric surgery has improved immensely. Now, through laparoscopic bariatric surgery, physicians have the ability to perform surgery using cameras to help make procedures less invasive and more enhancing – a method that is recognized by the bariatric community as quick and efficient, with quicker recovery times for patients.

Although there are many great advantages for both doctors and patients, the disadvantages laparoscopic surgery presents cannot be overlooked.

The disadvantages of laparoscopy include the expensive equipment involved in performing it. Not all hospital operating rooms can afford to offer it because of the cost involved. The cost to patients, however, seem to marginally less than the open procedure which is in large part due to less time spent in the hospital following the procedure. **Costs for laparoscopic bariatric surgery vary from hospital to hospital and from patient to patient. Consult your physician for more information.

The other major issue is the need for surgeons to take special training in performing the many operations that are available by this means.

The need for additional training is because laparoscopic surgeons leave the familiar territory of a three-dimensional operating field to working on a two-dimensional flat video display. The shift requires some degree of practice moving around long laparoscopic instruments while handling delicate tissues. Despite these temporary disadvantages, with the proper training, surgeons are able to adapt to this means of operating.

Additionally, the laparoscopic approach often takes a bit more operating time than the traditional ”open” approach. The amount of time the operation takes is not significant to the outcome of the surgery, but it can increase the risk of developing blood clots or wound infections. The longer time on the operating table may affect patients with severe sleep apnea or heart disease and perhaps should be avoided by those patients.

Other complications like wound infections, leaks from staple-line breakdown, marginal ulcers, various pulmonary problems, and blood clots in the legs -- may pose possible risks. Other problems include pouch dilitation, persistent vomiting, gallstones, or failure to lose weight.  In the long term, nutrition deficiencies -- such as deficiencies of vitamin B-12, folate, and iron -- are common after gastric bypass and must be treated.

Another potential result of this operation is ”dumping syndrome”, which is characterized by abdominal pain and diarrhea. Sometime these symptoms may not respond to conservative measures and may be troublesome to the patient. Women who become pregnant after these surgical procedures need special attention from the clinical care team.

The data suggest that complication rates relating to the laparoscopic approach are equal to or less than the rates relating to the conventional approach.

In most cases however, the minimal access, laparoscopic surgical approach to the treatment of obesity may reduce postoperative pain and medication levels, promote faster return of bowel function, and improved cosmetic results.

Laparoscopy cannot always be performed on everyone. Some patients with many prior operations may have so much scar tissue within the body that a safe operation cannot be done. In time, the disadvantages involved in laparoscopic bariatric surgery may be overcome with continued laparoscopic research and development.