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Difference between Laparoscopy and Laparotomy

Difference between Laparoscopy and Laparotomy

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Laparoscopy and laparotomy are common surgical procedures. They help perform surgeries in the abdominal and pelvic region. The primary difference between laparoscopy and laparotomy is the size of the incision.

“Laparo” means “Wall of the abdomen” in Ancient Greek. Further, the use of laparoscopy and laparotomy differs from ailment to ailment.

The key differences between laparoscopy and laparotomy are many. The following section explains the differences.

What are the Key Differences Between Laparoscopy and Laparotomy?

The primary difference is the type of incision laparoscopy and laparotomy make. There are certain types of incisions in Laparoscopy such as Single incision

Laparoscopy is often called “Keyhole Surgery” as it makes only a small incision. Surgeons view the insides of the body and operate through this cavity.

Laparotomy cuts open the wall of the abdomen to perform surgery.Laparoscopy is usually used for biopsy. Laparotomy aids in lithotomy, appendectomy, and other organ removal.

Laparotomy is also undertaken to remove pelvic organs in women.The time taken to recover, rate of infection, and degree of pain are lesser for laparoscopic surgery than for laparotomy.

Understanding the Laparoscopic Surgery

Laparoscopic surgery is also called “minimally invasive surgery”. It makes smaller incisions on the needed area of the abdomen to operate.

Biopsy and minor surgeries such as cyst removal, and appendix removal use laparoscopy. Laparoscopy is a recent development in medical procedures. The instruments used in laparoscopy are expensive and demand high expertise.

Understanding the Laparotomy Surgery

Laparotomy is also called “celiotomy”. The surgery makes a large incision on the abdominal wall. It cuts through tissues and fascia to gain access to organs in the abdominal and pelvic region.

A sagittal midline incision is the standard incision made during laparotomy.A paramedian is a vertical incision. This incision cuts one side of the sagittal plane for better access to the kidneys and adrenal glands.

A transverse incision is a horizontal incision made below the navel. A pfannenstial incision makes cuts above the pubic bones for pelvic laparotomy.

A subcostal incision or Kocher incision is a diagonal incision. It helps to operate on organs such as the spleen, liver, bile duct, etc.
A chevron or rooftop incision is also a subcostal incision. It makes an incision on either side of the midline. It permits access to kidneys and organs in the middle region.

What Surgeries are Performed Laparoscopically?

Surgeries that use laparoscopy include:

  • Cholecystectomy
  • Appendectomy
  • Lithotomy
  • Endometriosis
  • Ovaries removal
  • Ovarian cysts removal
  • Adhesion removal etc.

When do Surgeons Choose Laparotomy?

Medical practitioners have administered laparotomy for ages. Laparotomy is the go-to surgical procedure during most of the emergencies.
Surgeons also choose laparotomy for the removal of organs in the peritoneal cavity.

Is Laparoscopy a Common Surgical Method?

Yes, laparoscopy is a common surgical method nowadays. Surgeons suggest laparoscopy to diagnose any disease condition or for biopsies.

It is an alternative to cutting open through the abdomen. Minor surgeries can employ laparoscopy.

How Common is Laparotomy?

C-section is normally carried out through laparotomy. Laparotomy is also used to identify cancer stage and is called “Staging Laparotomy.”

Advantages

The advantages of laparoscopy and laparotomy are many and vary. The choice of surgery though depends upon the condition of the disease and the treatment proposed.

What are the Advantages of Laparoscopic Surgery?

  • For minor surgeries and biopsies, a laparoscopic surgery would be helpful.
  • The smaller incisions made in laparoscopic surgery heal quicker and leave no scar.
  • The recovery rate post-surgery is also faster when compared to laparotomy.
  • Since the abdominal wall is not cut open the infection rate is negligible and the pain bearable.

What are the Advantages of Laparotomy Surgery?

  • Laparotomy gives a shorter learning curve for surgeons making it easier and quicker to diagnose and treat diseases. The mobility range of medical instruments in laparotomy is also higher.
  • Laparotomy has less chance for cancer spoilage as well due to wider mobility.

Complications

Alongside its benefits, both laparoscopy and laparotomy have its side-effects as well. Though the choice of surgery is based upon the degree of emergency and ailment condition it is advisable to be aware of the complications both these surgeries entail.

What are the Complications of Laparoscopic Surgery?

Laparoscopic surgery is dependent on the image transmitted by the camera set on the laparoscope.
Surgeons have limited mobility through the keyhole incision and there is an unfortunate possibility of cancer spillage to other body parts and planes.

What are the Complications of Laparotomy Surgery?

The large incision made by laparotomy can leave surgical scars on the abdomen. The rate of infection in laparoscopic surgery is also higher as it opens up the abdominal wall.

Patients also will suffer quite some pain post laparotomy.

Recovery Time

The rate of recovery differs from laparoscopy to laparotomy. The recovery time for laparotomy is higher than the recovery time for laparoscopy.

What is the Recovery Time for Laparoscopic Surgery?

Laparoscopy does not need hospitalization for more than a day. Within a week patients can carry out their normal activities. The incision scars also heal faster.

What is the Recovery Time for Laparotomy Surgery?

Laparotomy requires at least six weeks of hospitalization. Internal bleeding and possible infection demand long hospitalization. The recovery period would vary from the kind of laparotomy employed. It takes into account other related procedures undertaken as well.
Patients would have to consult their doctor before discharge. They may have to take precautionary steps for quite some time post-laparotomy.

Conclusion

The primary difference between a laparoscopy and a laparotomy is the length of incisions. Laparoscopy is a recent development with the need for expensive instruments.

Laparotomy is a widely used procedure. The choice of surgery though depends upon the nature and degree of ailment and urgency.
To know more about the details of laparoscopy and laparotomy contact a surgeon.

Dr. K. Amilthan MBBS., MS., FMAS., FALS.

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