Host response to laparoscopic surgery: mechanisms and clinical correlates

Minimal access surgery has revolutionized the treatment of a variety of surgical diseases, partly because it is associated with less patient morbidity than nonlaparoscopic surgical procedures. Emerging evidence suggests that alteration in the host response after laparoscopic procedures has significa...

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Bibliographic Details
Published in:Canadian Journal of Surgery 1998-04, Vol.41 (2), p.103-111
Main Authors: Hackam, D J, Rotstein, O D
Format: Article
Language:English
Subjects:
Humans
Immunosuppression
Laparoscopy
Microsurgery
Neurosecretory Systems - metabolism
Pain, Postoperative - prevention & control
Postoperative Complications - immunology
Postoperative Complications - metabolism
Postoperative Complications - prevention & control
Surgical Biology for the Clinician
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Summary:Minimal access surgery has revolutionized the treatment of a variety of surgical diseases, partly because it is associated with less patient morbidity than nonlaparoscopic surgical procedures. Emerging evidence suggests that alteration in the host response after laparoscopic procedures has significantly contributed to the improved postoperative course. Laparoscopy modulates both afferent stimuli (including tissue trauma, pain and wound size) and efferent responses (via neuroendocrine, metabolic, immunologic and cardiorespiratory systems). These effects lead to a decrease in postoperative pain, fever and disability. Laparoscopy mediates these effects through reduced wound size, the activities of endotoxin and immunomodulatory actions of the insufflated gas, resulting in impaired macrophage activity. Although clearly beneficial in reducing postoperative morbidity after elective surgery, this immunosuppression could increase the risk of complications during procedures for infection or neoplasia.
ISSN:0008-428X
1488-2310