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Laproscope VS. "Open" Colectomy

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Posted 3/14/2005 12:38 PM (GMT 0)
I am scheduled for a colectomy next week, which my doctor plans to do "open" , long incision, etc. and have done some research on my own.  Almost everything I read talks about laproscopic operations.  Does this mean my doctor is out of date?  All gall bladdders are removed with a laroscope now and in Colectomies the laproscope, according to what I read, means shorter recovery, shorter hospital stay, less pain, etc.

I wonder how a patient gets answers to things like this.  Doctors look at you like you are an idiot.  Does anyone here have information or an informed opinion?

Posted 3/15/2005 12:24 AM (GMT 0)
Hi Mark,
I had an laproscopic subtotal colectomy a few months ago. I had my colon surgeon as well as the laproscopic specialist in the operating room--it took months and months to get a date for surgery because, as my surgeon explained to me --for colon laproscopic surgery the surgeon needs to be highly trained--My surgeon did not have much experience with lap surgery so she wanted a specialist with her. The reason I waited so long was becasue I really wanted the lap surgery--i could have had the open colectomy months before. I had open stomach and esophogus surgery when i was 19 and was in the hospital for 11 days. The same sugery i had 12 years ago can now be performed lap with only a one night stay in the hospital! I think there is definite advantage to laproscopic.
I did have less pain with the lap surgery and the recovery was much easier. Maybe your surgeon can find a lap specialist?
I forgot to mention--my surgeon said that there is always the possibility of starting the surgery laproscopically and then switching to the open surgery if they can't get a good view of the colon through the laproscope --I guess that happens quite often, according to her.
i hope I'm not scaring you! I have to have the rest of my colon removed in April or May and this time I will probably have to have open surgery becasue of scar tissue. The one good thing about open surgery is that it is much shorter, 1 -1 1/2 hours as opposed to 3-4 hours for lap. So you will be under anethesia less time, which is always a good thing!
take care,
sara
Posted 3/15/2005 12:26 AM (GMT 0)

Hi Mark,

well i had a laproscopic j-pouch done, and i know from my surgeon they like to do the laproscopics only on those relatively young and relatively healthy individuals that come their way. But the rate of complications increase with the laproscope, and if you have had prior surgery and more scar tissue has built up its harder to see with the scope. 

If you are unsure you are getting the right care, i would say you should get another opinion, i dont care how close you are to surgery. Its your body and you can back out whenever your little heart desires. This is a major operation, and you want to be comfortable you made the right decision and that you chose the right surgeon...

Docs really dont tell you a whole lot if you dont walk in with a list of questions written down and insist on a sit-down.  They get paid for their consults, so you should get the time to ask your questions...its your body...you are letting THEM do work on you.

I wish you the best of luck on this, but please let me know how it turns out, what you decide. I would say my recovery was really rough regardless of the laproscopic though..i had 2 blockages and a fistula that formed from trauma from surgery.  Its rough, but youll power through just fine no matter what surgery you have...just keep your chin up!!!

~Eileen

Posted 3/17/2005 10:00 PM (GMT 0)

Hi Mark. I had my colectomy last October and I like you did some investigating. I had the same questions, but I was happy with the responses I got. My op was due to Crohn's disease, and my colon was sent to Clevand (from Atlanta) for testing, so it was better to be in one piece. My surgeon also stated that due to my age, size, and health, the recovery period would be shorter than the average. He was right. I had the op on a Friday, was released to go home the following Tuesday, had the staples removed Tursday, and was released for "light duty" two weeks after the operation. I did have the bag and took it pretty easy, but I did play a round of golf three weeks after the op with a "light" swing pain free.  I don't stay in the gym nor do I workout regularly, but I do try to be active and I think I'm still young at 34. I'm 6'3" and weighed about 190 at the time. I didn't even get the Vicodin script filled that he sent home with me. My scar is only about 6 inches. I do have a great surgeon in my opinion. I guess this can have an effect on how things go post-op.

Good luck!!!

Posted 7/15/2008 6:44 PM (GMT 0)
I just had a colectomy with the open method. Huge scar but it was a blessing in disguise because my physician did exploratory before performing the colectomy. He found a hernia from when I had a tubal ligation three years ago. The way it was positioned, you couldn't see it on xrays or ct scans.
Posted 7/15/2008 10:07 PM (GMT 0)
i had mine open and i tell you from my experience. that it was great.................... i honestly felt better my doctor opening me up and really seeing what he was doing. I know they say lap is easier to recover. but i dont get it. because i have read how many of the people on here had the lap and they have like 3 inch cut on 3 different spots. mine is a 4.5 inch cut in the middle and i have been healing wonderfuly. i had my surgery on the 20th of june . so that means a 3 1/2 weeks now and i feel great. I almost feel to good. that i worry it is to good to be true. and or that i might over due it because i feel so good. I seen lap done on you tube and to me i thought it seemed like the dr was more guess on what he was cutting. I just thought it seemed to be alot more exact on what they needed to do with open colectomy. sure i hurt like crazy when i woke up but after 3 weeks now i feel great. just thougth i would let you know.. 4.5 inches verses 3 inches in 3 spots . i think i will take open any day. also i heard they have to fill you up with ALOT of air in order to even do the lap. i never had ANY gas pains at all after my surgery. NOT ONE TIME . Good luck
Posted 7/15/2008 11:24 PM (GMT 0)

Hi Mark,

I had my entire colon removed laprascopically.  Not all surgeons will do this, for two man reasons--as saramarie said, not all are trained to do this, and also they may not want to if you have had any other abdominal surgeries (the scar tissue from past surgeries can make it difficult to perform lap. surgery.)

I am 27 and had no prior surgeries.  I am very happy with my choice--I had about 5 tiny, 1cm long incisions (they have healed and you cannot even see a scar from these), and one about 5 inch "bikini" incision (this goes across the belly, just above the pubic area).  I also was sewn shut with dissolving stitches, not staples, since the inscions were so small.  Made me happy!  Staple removal did not sound pleasant, but I am sure it is not that bad.

Good luck. If you are really interested in lap. surgery, could you find another surgeon (maybe in a nearby city) who would perform one if you are a good candidate?

E

Posted 7/15/2008 11:32 PM (GMT 0)
I had a laprascopic colectomy done. I had to go to the Mayo Clinic for it because none of the doctors in my home town knew how to perform it this way, only open. My good friend had it here at home, open, and had a MUCH longer recovery and her scar is very large. My scar is only like 4 inches and five days after surgery I was using the elliptical trainer at the gym (my surgeon okayed it). Many colon and rectal surgeons do not have the knowledge to do it laprascopically because it takes A LOT of extra training, and most surgeons do not want to invest the time and effort. If you have access to a surgeon who can do is laprascopically I would highly recommend it.
Posted 7/16/2008 5:20 AM (GMT 0)

My 17 year old daughter just had a full incision colectomy on July 3. We consulted with 2 different surgeons who both do the surgery with full incisions. The doctor we decided to go with feels that although there are many surgeries that are done laproscopically, this surgery is best done open because of how diseased the colon may be and because of the number of other organs very close by. I was more concerned about her having a scar than she was. We thought about consulting a surgeon in NYC (highly recommended) who performs it laproscopically (Dr. Milsom) but decided that we were very satified with the quality and experience of the surgeons on Long Island. Besides the NYC doctor does not accept insurance.

The incision isn't as bad as I expected. My daughter still does not mind it much. It is healing nicely and I believe her aches and pains (not bad enough for pain meds) isn't much different than if she had laproscopic surgery. It is still major abdominal surgery.

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