Principles of Cancer Biology in Relation to Minimal Access Surgical Techniques

Recurrence in abdominal incisions, whether created to allow traditional "open" operation or laparoscopic approaches, is related in many ways to the principle of tumor biology. Tissue trauma enhances the growth of many types of malignant cells and is related to the recurrences of being observed after laparoscopic approaches. Additional mechanisms such as the effect of pneumoperitoneum may play a role in the dispersement of cells at the time of manipulation for diagnosis or therapy of cancer. Techniques must be developed to reduce the potential for spillage of cancer cells and the dissemination of cells at the time of laparoscopy. Once access site recurrence develops, metastasis of tumor to other sites may be consequence. Ongoing research regarding the effects of laparoscopic techniques on tumor biology must be supported in order to limit the complication of access site recurrence once additional techniques for therapeutic manipulation become available.