You have the option of doing it via whatever approach you want. There are still reasons to do cases open, just as there are reasons to do a case laparoscopically when possible. Keep in mind that patient comorbidities, prior surgical history, disease process and other factors all contribute to the decision to approach a case in a certain way. What's best for one patient may not be what's best for the next.
Surgeon comfort also is a factor--if the surgeon does not do a high volume of case x via the lap approach, s/he may be more particular about which patients to do laparoscopically until a certain level of comfort is achieved to begin expanding to cases that may be more difficult via that approach. There are also some old school guys out there who just don't want to learn new techniques and plan to just do everything open until they retire.
I've also had a few (usually older) patients decline a lap procedure for various reasons
@SurgeDO : you should ask the surgeon you are working with if he has a reason to do a case via a certain approach for your own education. you may get a "I don't do/not comfortable with lap colons" for a response, or you may get a "the patient has a history of x, y, z and I am concerned about a, b, c". Sometimes something you didn't consider may actually be a significant factor in the surgeon's decision. Often times other specialties don't appreciate some of the nuances we consider when evaluating a patient, because they don't always know the anatomic or other surgery-specific issues.
