Failure rates: Laparoscopic versus Open Surgeries

Back when I had surgery (1992) there was no laparoscopic option.  It was open or nothing. I seem to have had a successful outcome as 23 years later I still have my J Pouch.  I have struggled with pouchitis but I have mostly controlled it over 20 years with antibiotics.

 

Your question is interesting to me, but what I would be more interested in hearing is how surgeons would answer this question.

Mine has been successful, too, and was completed as an open surgery. Mine is one year older than CT's, and is 24 years old. I was also young and "relatively" healthy at the time of surgery (haha... how is someone with a diseased pan-colitis colon considered "healthy" you might ask? but I wasn't as ill as some (or perhaps I was young and in denial? I never had pain, ever, thru my UC years). 

 

I'd be interested in the statistics and surgeon's views, too. 

Good question.
I initially had lapro.
But was open twice within three weeks twice... First time  they opened me they I had a blockage they could not find without going in so they took the bag off and hooked me up..... second I was bleeding internally.  So I am just assuming now they layed out everything both times and put it back.
I am neither nor!
But good question.  Interesting to see what there is to say.
Richard.

One step open surgery 19 years ago, after suffering with colitis for 15 years. Pretty sick when I had the surgery. It really was the end of my colon's shelf life. 

 

I'm 99% happy with my j-pouch. Had pouchitis and cuffitis a few times. But when I'm feeling good - I'm feeling great. 100% normal.  Do not take any drugs. 

 

C-jay

John, my son had his colon removed and j-pouch removed in one surgery done laparoscopicly.  His take down was also done laparoscopiclu as well.  Them we found he had a micro tear in the pouch.  They reversed him in March but they opened him up completely.  I personally don't believe the micro tear had anything to do with the surgery being performed by the robot.  Oh, he had the first two surgeries with the DiVinci Robot.

 

diane

 

Laparoscopic and no issues with the pouch so far, it's 5 months old. You pose a fascinating question.

I had an open procedure. Oodles of complications. Wound infection, presacral abscess, deep vein thrombosis, cuffitis, Pouchitis, incisional hernia.

 

A decade or so later i had a laparoscopic adrenalectomy without issue. I think it has more to do with what is going on at the time of surgery.

 

Jan

 

 

lapro at Cleveland Clinic, nothing but issues. Disconnected jpouch for over a year now.

always wonder if a different surgeon did surgery, would outcome have been different. I almost chose Remzi, but my surgeon was highly recommended.

My j pouch surgery was laparoscopic. No issues at all.  My uncle had a lapo j pouch procedure as well...no problems. My sister had an open j pouch procedure...no problems for her. 

There have been a number of comparative studies on the subject. This one compiled all the results and over the long term there was no difference in the outcome.

http://www.ncbi.nlm.nih.gov/pubmed/23560590

 

Some studies showed that the only difference was a shortened hospital stay and a more cosmetic result, but no difference in failure or complication rate. It is important to know that even in the most skilled hands, there are complications and failures.

 

Jan

Very interesting, Jan!   I found it interesting that "daily pad use" and "# of bowel movements" were keys in the report.  And the conclusion:  "However, the present evidence is underpowered to detect true differences in adverse event rates."

 

 

 

Yeah. One problem with a meta analysis is that it just collates data from other studies. Individual studies have different study parameters and only overlap so much. The main take away for me is that there did not seem to be a difference for major complications.

 

Jan

 

Mine were open surgeries 8 weeks apart and 6 months later he had to open the midline incision again to do incisional hernia repair, 3 open surgeries in 8 months.  My husband told him he should have installed a zipper  My take down was complicated by a large abscess he had to cut out under my original incision.  I had to pack that hole of 2"Deep x 2"Long and 1.25 Wide for several months. It was a "dirty" incision and had to be left open to heal.  During the hernia repair at least he closed that up better, with a tiny tummy tuck, so it no longer looked like I had 2 belly buttons!

 

I'd had open surgeries in my abdomen so all together I now have a bunch of painful adhesions and scaring.

 

My pouch problems are not because of my pouches construction.  He did an excellent job, per other Mayo GI's.  I just ended up with chronic cuffitis, chronic pouchitis and IPS.  I had aroudn 8 months with c.diff too.  

 

If I had it to do all over again I would have the surgery where they hand sew the pouch to the sphincter muscles, therefore no cuffitis.  I would also prefer it be laproscopic to avoid any further scaring left by the removal of my lady parts.  There are no "do overs".

 

My husband had Davinchi robot laprosocopic surgery to remove is entire cancerous prostate.  I know it is a different problem all together but his recovery was remarkable. The radiation option would have been more grueling in our opinion. Just in case any of you guys face this decision down the line. 

 

Both surgeries Laproscopic takedown was Jan2014 all good here.

My surgery was robotic assisted, and completely closed.  I have 6 small scars (less than 1").  No complications at all.  5 weeks post take down and the results so far are well beyond my expectations.  Going 4 or so times per day, and I can hold it a pretty long time if needed.  I actually went over 10 hrs. this past Tuesday between BM's (went 3x that day).  I'm ecstatic with my outcome to say the least.