Open vs. laparoscopic procedures in bariatric surgery

Laparoscopic GBP is a complex advanced laparoscopic operation that accomplishes the same objectives as open GBP but avoids a large upper midline abdominal incision. The differences between laparoscopic and open bariatric surgery are the method of access and exposure. By reducing the size of the surgical incision and the operative trauma associated with the operative exposure, the surgical insult should be less after laparoscopic compared to open bariatric surgery. We reported a reduction in the surgical insult after laparoscopic GBP and believe that this is the physiologic basis for the observed clinical advantages of laparoscopic GBP. The important clinical advantages of laparoscopic GBP are not the reduced length of hospitalization but the reduction in postoperative pain, lower rate of wound-related complications, and faster recovery. Given the currently available evidence-based data, laparoscopic bariatric surgery should be considered the new standard for the treatment of morbid obesity as long as the surgeon has passed the learning curve of the laparoscopic approach.