Advantages and Disadvantages of Laparoscopic surgery
- Aug 12, 2017 -

Advantages

There are a number of advantages to the patient with laparoscopic surgery versus an open procedure. These include:

  • Reduced hemorrhaging, which reduces the chance of needing a blood transfusion.

  • Smaller incision, which reduces pain and shortens recovery time, as well as resulting in less post-operative scarring.

  • Less pain, leading to less pain medication needed.

  • Although procedure times are usually slightly longer, hospital stay is less, and often with a same day discharge which leads to a faster return to everyday living.

  • Reduced exposure of internal organs to possible external contaminants thereby reduced risk of acquiring infections.

  • There are more indications for laparoscopic surgery in gastrointestinal emergencies as the field develops.

Although laparoscopy in adult age group is widely accepted, its advantages in pediatric age group is questioned. Benefits of laparoscopy appears to recede with younger age. Efficacy of laparoscopy is inferior to open surgery in certain conditions such as pyloromyotomy for Infantile hypertrophic pyloric stenosis. Although laparoscopic appendectomy has lesser wound problems than open surgery, the former is associated with more intra-abdominal abscesses.

Disadvantages

While laparoscopic surgery is clearly advantageous in terms of patient outcomes, the procedure is more difficult from the surgeon's perspective when compared to traditional, open surgery:

  • The surgeon has limited range of motion at the surgical site resulting in a loss of dexterity.

  • Poor depth perception.

  • Surgeons must use tools to interact with tissue rather than manipulate it directly with their hands. This results in an inability to accurately judge how much force is being applied to tissue as well as a risk of damaging tissue by applying more force than necessary. This limitation also reduces tactile sensation, making it more difficult for the surgeon to feel tissue (sometimes an important diagnostic tool, such as when palpating for tumors) and making delicate operations such as tying sutures more difficult.

  • The tool endpoints move in the opposite direction to the surgeon's hands due to the pivot point, making laparoscopic surgery a non-intuitive motor skill that is difficult to learn. This is called the Fulcrum effect

  • Some surgeries (carpal tunnel for instance) generally turn out better for the patient when the area can be opened up, allowing the surgeon to see "the whole picture" surrounding physiology, to better address the issue at hand. In this regard, keyhole surgery can be a disadvantage.


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