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Crohn's Disease Forum » Surgery » Open or lap surgery for exploratory CD surgery?


01-26-2013, 08:23 AM   #1
Mark in Seattle
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Open or lap surgery for exploratory CD surgery?

Anyone got a feel for how frequently lap surgery is being utilized for exploratory CD surgery these days? I've talked to a couple of local surgeons in the Seattle area, both of whom recommend open surgery in my case. But it seems like I read more about lap surgery becoming adopted in some other areas, which makes me wonder whether it's worth looking into further or not.
01-26-2013, 01:07 PM   #2
xSophiexx
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Im having an exploratory laparoscopy in next couple of weeks following failure of steroids, aza and infliximab. a thickening of bowel was seen on mri, couldn't find it with colonoscopy so this is the next step as all symptoms still present. Im in th UK. hope this helps
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Diagnosed CD May 2012
Ileum and Jejunum

Ileocaecal Resection 12th June 2013

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01-26-2013, 01:08 PM   #3
nogutsnoglory
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I'd get another opinion because laparoscopic is very common now even for major surgery. I had 2 feet removed and it was all lap.
01-26-2013, 06:58 PM   #4
Kev
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I've had both. This is just my personal experience, and every case is different. Lapro. is growing in popularity because it involves minimal cutting. I ended up with 5 small incisions that healed very quickly. However, I experienced a lot of discomfort because they inflate the abdomen (or did in my case) with inert gas. It felt like a prizefighter used my ribs as a heavy punching bag for a long time. And, because of the very small incisions, everything they removed was taken out piecemeal, making post op analysis very difficult. This resulted in a major delay getting my diagnosis right. Now, my last op was old school. Incision from groin to belly button. I have an issue with the scar... I'm embarrassed by it as I see it as a constant reminder of my illness. However, the surgery itself, and my recovery, was figuratively a walk in the park. Operated on around 7:30 AM, up out of bed for my 1st post op walk 5 hours later (with the assistance of 2 nurses). I only spent 5 days in hospital, and at home I cared for myself... had to.. no one there at the time to provide any assistance. (My g/f at the time was uncomfortable around 'sick' people, and at 5' 2", 105 lbs, wasn't in any position to help 6' 3", 250 lb man up out of bed, or step into a shower, etc., anyway). All things being equal, the lap 'healed' faster but hurt longer (in my case) and prevented proper post op biopsy. The old way took longer to heal, but hurt less, and the surgeon got real 'hands on' access to my guts (he was right in there, not just looking thru a scope at a miniature image.). I don't think there is a 'right' answer to the question of lap or general surgery, just a 'better' choice dependent on personal circumstances at the time. One thing I think holds true (in my humble opinion) is that a surgical option should be considered a 'last' choice, as it is a permanent one.
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Dx'd July, 2006
Meds: Flagyl, Cipro, Pred, AZA.. to no effect
Low Dose Naltrexone Nov 2007 - May 2014
Remicade June 17th, 2014
01-26-2013, 07:06 PM   #5
Jennifer
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For my resection it was supposed to be laparoscopic but turned into hand assist (had about a 4 inch incision). You could request that it be done laparoscopic yet still wind up with a larger opening depending on what they find when they get in there. No harm in getting another opinion from another surgeon or a few more surgeons if possible even though you've already spoken to a couple. Its worth looking into if you don't want to have an open surgery although you may find that open surgery could be best for your case as the other surgeons suggested.
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Diagnosis: Crohn's in 1991 at age 9
Surgeries: 1 Small Bowel Resection in 1999; Central IV in 1991-92
Meds for CD: 6MP 50mg
Things I take: Tenormin 25mg (PVCs and Tachycardia), Junel, Tylenol 3, Omeprazole 20mg 2/day, Klonopin 1mg 2/day (anxiety), Restoril 15mg (insomnia), Claritin 20mg
Currently in: REMISSION Thought it was a flare but it's just scar tissue from my resection. Dealing with a stricture. Remission from my resection, 17 years and counting.
01-30-2013, 06:19 PM   #6
Mark in Seattle
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Thanks for the input everyone, it's given me some good perspectives to consider. I have no concerns about the scar. I was pleasantly surprised on my first surgery that my scar was about 6 inches or so, beginning a bit under my naval and going up and swerving right round my naval and ending an inch or two above. But the best part is that it is covered by hair, so it's not even visible when looking at my abdomen. And for my second surgery, the surgeon traced the same scar exactly. I don't know how many times they can use the same scar to enter me, but maybe there is no limit. In any case, the scar is the least of my worries. I hadn't thought about the air being pumped in for lap - but that is a good point, I've heard of that being aggravating to folks who had lap surgeries for GERD. I would not look further for any other surgeons in the Seattle area. For me, I'm either going with my local guy who advocates open surgery or else I would maybe consider flying to Mayo or some special IBD center, though other than Mayo, I'm not sure where that would be. Thanks...
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