Differences Between Open and Laparoscopic Surgery

The main difference between open surgery (sometimes called traditional surgery) and laparoscopic surgery is the types of incisions used to access the abdomen. Each type of surgery carries different benefits and risks and your surgeon will make a recommendation based on your individual situation.

Incisions used in Open vs. Laparoscopic Surgery

Laparoscopic surgery is known as minimally-invasive compared to open surgery because of the type of incisions used. In an open surgery, a single, large incision is used to cut through muscle and the abdominal wall. A large incision—sometimes as long as six to 12 inches—gives the surgeon full visibility of the area to be operated on, and enough space to perform the procedure.

Laparoscopic surgery uses several small incisions rather than one large one. In laparoscopic surgery, a device called a laparoscope is inserted into one of the incisions. A laparoscope is made up of a thin tube with a light and camera at the end. The camera sends images to the surgeon in real time. This view allows the surgeon to perform procedures without making larger incisions. A laparoscopy may be performed for diagnostic reasons or a laparoscopic approach may be used for a therapeutic procedure.

Risks and Complications

Because of the size of the incision, open surgery is sometimes associated with a longer recovery time. It also can put the patient at increased risk for pain, blood loss, and infection.

Laparoscopic surgery can carry fewer risks when compared to open surgery. The smaller incisions and less invasive contact with internal organs can mean a shorter recovery time with less pain. There is less risk of blood loss and infection as well.

For many types of surgery, a minimally-invasive approach has become the preferred method.

Recovery from Open and Laparoscopic Surgeries

Recovery time is generally shorter for laparoscopic versus open surgery, and there may be other benefits as well. With minimally-invasive surgery, you may:

• Have a shorter hospital stay
• Feel less pain at the incision site(s)
• Return to regular activities quicker
• Experience less internal scarring
• Have smaller (external) scars

Which Type of Surgery is Right for Me?

Your surgeon will talk with you about what type of surgery is best for your individual case. For many people, a laparoscopic surgery will be preferable, because it is minimally-invasive and therefore carries fewer risks. People who are at increased risk for bleeding or clotting problems may be recommended to have laparoscopic surgery.

Even minimally-invasive surgeries have some risks, however, and sometimes an open surgery may be recommended. If you have had prior abdominal surgeries, your doctor may recommend an open surgery because of scar tissue build-up that may prevent a minimally-invasive approach.

Robotic Surgery Options

Still other patients may be recommended to have robotic surgery. In this kind of surgery, a small single incision is made with robotic instrumentation, guided by an experienced surgeon.

Using a tiny camera giving the surgeon a live 3D, high-resolution image inside the body, the surgeon operates, using the robotic surgical instruments. The robotic instruments are finer and have more dexterity than the human wrist, allowing for a very precise surgical approach.

Learn more about different surgical approaches here.

Procedures We Offer

Abtin Khosravi, MD, FACS, specializes in traditional open surgery and minimally invasive surgical procedures. Dr. Khosravi works closely with each patient to determine what the safest and most effective surgical approach may be.

Some of the procedures we offer include:

Inguinal Hernia Repair

An inguinal hernia happens when the abdominal muscles have weakened, resulting in a bulge or tear in the groin area. Inguinal hernia repair can be performed as a traditional surgery, but is more commonly done as a laparoscopic or robotic surgery.

Ventral Hernia Repair

A ventral hernia can happen as a bulge or protrusion in the abdominal wall in an area weakened by a prior surgery, in the belly button area, or any other area of the abdominal wall. Ventral hernia repair can also be performed as an open, laparoscopic, or robotic surgery.

Gallbladder Removal

Gallbladder removal, or Cholecystectomy, to treat gallstones or other gallbladder disease is one of the most common surgeries performed in the U.S., done either laparoscopically or robotically.

Appendix Removal

The removal of the appendix to treat appendicitis is also a very common procedure. It is typically performed laparoscopically, but can be converted to an open surgery if needed.

Colon Resection

In a colon resection procedure is used to remove part of the colon that is diseased or damaged. Usually, this is done in a laparoscopic procedure, but may also be converted to an open surgery in some cases.

Anti Reflux Surgery

Gastroesophageal reflux disease (GERD) or acid reflux can be treated through non-surgical methods, but if lifestyle changes and medications are not effective, laparoscopic surgery can be used to resolve the condition. Rarely, if a laparoscopic approach is not appropriate, open or traditional surgery can be used.

Hiatal Hernia Repair

Hiatal hernia repair fixes herniated stomach tissue that is bulging between the abdomen and chest areas. This procedure is often performed laparoscopically or robotically.

Heller Myotomy

Heller myotomy treats achalasia, a reflex disorder of the lower esophageal sphincter. The surgical procedure cuts the muscles of the cardia (lower esophageal sphincter or LES) so that food and liquids can pass to the stomach. This procedure is performed laparoscopically.

Stomach Surgery

There are many different reasons for stomach surgery, including to treat ulcers, blockages, hemorrhaging, and tumors. Dr. Khosravi has extensive experience with these types of surgeries, which are usually done either laparoscopically or robotically.

Diagnostic Laparoscopy

This laparoscopic procedure is performed when a patient has abdominal symptoms or problems and the benefits of a full and proper diagnosis through minimally-invasive laparoscopy outweigh the risks.

Biopsies and Dissections

Sometimes, a diagnosis requires a biopsy sample or dissection in order to guide treatment. Minimally-invasive robotic or laparoscopic biopsies and dissections are procedures that surgeons use to gain access to tissue samples needed in these cases.

Spleen Removal

There are a number of problems that may require the need for a spleen removal (or splenectomy). Usually this procedure can be performed laparoscopically or robotically, but sometimes the size of the spleen makes these minimally-invasive approaches impossible. Techniques can sometimes be used to shrink the spleen prior to surgery, but occasionally, the surgery is converted to a traditional, open technique.

Contact us to learn more

Our practice is a leading provider of open and minimally-invasive laparoscopic and robotic surgeries, serving patients in the Orange County and greater Los Angeles metropolitan area.

To learn more about our surgical procedures, call (714)-541-4996 or request an appointment online.

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