Laparascopic vs. open ileocecectomy

[BoFin1]

laparascopic vs. open ileocecectomy

Under what circumstances will a doctor chose to do laparascopic ileocectomy
instead of an open procedure? When is it preferable to do an open procedure?
In what situations might a surgeon start with the laparascopic but need to change to the open procedure?

 

[tiloah]

I think laparoscopic is preferable if possible. I'm sure there are many variables they consider when deciding. I would imagine the extent of the damage/amount of diseased tissue would affect which procedure is used. I had laparoscopic with hand assist, which was like halfway between each.

Are you being considered for surgery? Has your doctor told you which procedure they prefer, and if so can you ask what their reasoning was behind the choice?

Welcome to the forum, by the way.

 

[SarahAnne]

I am having surgery early October, my surgeon is going to attempt to do it laparascopically...but he also warned me that all sorts of factors could turn it into an open procedure, i.e., scar tissue, more diseased area than anticipated, whether he is going to do a stricureplasty or a resection. So basically, it depends.

He had me sign consent forms for both procedures and explained both procedures in detail already, so we are covered either way when I go in.

 

[DustyKat]

Most surgeons will opt for laparoscopic and then change to open if need be.

The surgeon will do their utmost to prepare themselves for what awaits...scans etc...but until they actually start the procedure they don't really know.

My son had surgery in April and when he went for review in March the surgeon said then that he didn't think he could do the op laparoscopically and as it turned out he was right. My son already had complications and had a pigtail drain insitu.
They did, however, start laparoscopically and although he had scans they didn't show he had a second fistula with abscess adhered to his abdominal wall. So that was another reason to go open.

Dusty. xxx

 

[Slim Johnson]

I am sure opinions are as varied as the doctors.

I had a surgical consultation on Monday, 9/26. The doctor told me that the best means to address the issues at hand was an open surgery. He told me there was no way that a lap surgeon could do a procedure, then look me in the eye and honestly claim that they caught everything. That the only means of ensuring everything has been dealt with is to go open, examine the entire intestine, inch by inch. To me this makes sense.

I am covered in tattoo, so getting scars on my abdomen is something of a concern because I have tattoo that I would hate to see get cut up. The reality is that my health is more important than my tattoo, and I would rather go under surgery once, knowing nothing was missed, rather than risking a doctor missing something because the camera didn't reveal something. I had a lap hernia repair in '06, and the surgeon claimed that my intestine was healthy... BOY was he wrong!!!

Recovery time may be longer with an open surgery. I don't really care about that. I do care about having something missed, only to have another surgery to get what was missed. Not to say that We only ever have one surgery.. I just tend to agree with this particular surgeons view. YMMV.

 

[tiloah]

That's a good point Slim Johnnson. In my case the inflammation was in one specific area and it was straightforward. If there was a question of inflammation somewhere else or if more than one area was going to be worked on, open surgery may have been a better choice for me. But in my case laparoscopic "with hand assist" was the right choice because of that.

 

[Slim Johnson]

That's a good point Slim Johnnson. In my case the inflammation was in one specific area and it was straightforward. If there was a question of inflammation somewhere else or if more than one area was going to be worked on, open surgery may have been a better choice for me. But in my case laparoscopic "with hand assist" was the right choice because of that.

:voodoo:

*feeling jealous*

 

[tiloah]

:voodoo:

*feeling jealous*

If you talked to me pre-op you would *not* be jealous, I promise you.

 

[Slim Johnson]

If you talked to me pre-op you would *not* be jealous, I promise you.

That may be.. I vividly remember my last small bowel follow through. The fistulae resembled something of a spiderweb. The radiologist had even suspected an obstruction, telling me that the fistulae were what was allowing me to digest food past my Ileum. I protested this opinion, because I was having decent BM's at the time. His report to my GI stated that there was not obstruction, however there were several fistuale, and a VERY narrow terminal Ileum. The way I figure it, I am a salad away from the ER.:stinks:

 

[tiloah]

That may be.. I vividly remember my last small bowel follow through. The fistulae resembled something of a spiderweb. The radiologist had even suspected an obstruction, telling me that the fistulae were what was allowing me to digest food past my Ileum. I protested this opinion, because I was having decent BM's at the time. His report to my GI stated that there was not obstruction, however there were several fistuale, and a VERY narrow terminal Ileum. The way I figure it, I am a salad away from the ER.:stinks:

Well I hope your surgery goes well. I can't even put to words what a difference it made for me.