Comparative study between open and closed technique in laparoscopy in obese patients

Background The introduction of operative video-laparoscopy marked a major shift in surgical practice, replacing many traditional open procedures. Aim This work aimed to compare open versus closed technique in laparoscopic surgery for obese patients. Patients and methods This prospective comparative study was carried out on 50 patients aged between 20 and 60 years and with a BMI greater than or equal to 30 at the hospital of Tanta University. Two equal groups of patients were formed by random allocation: the open technique group and the closed technique group. Results Statistically significant lower vascularity, pigmentation, pliability, thickness subscale scores, and overall scar scores after 1 week of the procedure in patients with the closed technique than in patients with the open technique ( P <0.05). Statistically significant lower pliability, thickness subscale scores, and overall scar scores after 1 month of the procedure in patients with the closed technique than in patients with the open technique ( P <0.05). Statistically significant lower pliability, thickness subscale scores, and overall scar scores after 3 months of the procedure in patients with the closed technique than in those with the open technique. Conclusions The closed technique in laparoscopic surgery for obese patients demonstrated superior postoperative outcomes, including reduced pain and improved wound healing, as evidenced by decreased redness, warmth, and tenderness. The closed technique provided superior cosmetic outcomes, demonstrated by reduced pain levels and better scar appearance when compared with the open approach. Nevertheless, it required a longer operative time than the open method.