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Updated: Aug 6, 2026
Surgical Closure of Equine Abdomen, Prevention, and Management of Incisional Complications
Published on: May 10, 2024
Infective complications in laparoscopic surgery
Luigi Boni1, Angelo Benevento, Francesca Rovera
1Department of Surgical Sciences, University of Insubria, Varese, Italy. bonil@tin.it
Background And Purpose:
One of the main benefits of minimally invasive surgery compared with open surgery is the significant reduction in the incidence of postoperative infections. Possible explanations include the smaller incision, minimal use of central venous catheters for parenteral nutrition, faster mobilization, reduction in postoperative pain, and better preservation of immune system function with a limited inflammatory response to tissue injury. We compare the incidence of postoperative infections after the most common laparoscopic surgical procedures with that after the corresponding open operation, and review the possible mechanisms behind these results.
Method:
Review of the pertinent literature.
Results:
Several randomized controlled trials (RCTs), as well as most retrospective studies, show a significant reduction in incisional complications with laparoscopic cholecystectomy in comparison with open surgery (mean 1.1% vs. 4%), as well as in urinary tract and pulmonary infections. In colorectal resection, laparoscopic surgery was characterized by a significant reduction in surgical site infections (mean 5% vs. 9.5%), and the infections that did occur tended to be less severe. Again, there were fewer urinary and pulmonary infections postoperatively. Acute appendicitis represents an interesting setting to study the effect of minimally invasive surgery on infections, as it involves a potentially contaminated field. Most of the results confirm that the rates of surgical site (mean 2% versus 8%) and respiratory (mean 0.3% versus 3%) infections favor laparoscopic surgery, but minimally invasive surgery seems to be characterized by a higher incidence of postoperative intra-abdominal abscess. The laparoscopic approach to splenectomy is clearly superior to standard laparotomy in terms of postoperative complications, including infections, although the rate of overwhelming postsplenectomy infection (OPSI) remains similar because this complication is related more to spleen removal than to the surgical approach.
Conclusions:
Most of the literature is in agreement that laparoscopic surgery is associated with better preservation of immune function and a reduction of the inflammatory response compared with open surgery. The rate of postoperative infections seems to be significantly lower.
Insights
Minimally invasive surgery, such as laparoscopic procedures, significantly reduces postoperative infections compared to open surgery. This benefit is seen across various procedures, including cholecystectomy and colorectal resection, due to factors like smaller incisions and preserved immune function.
Area of Science:
- Surgical Innovation
- Infectious Disease Epidemiology
- Comparative Effectiveness Research
Background:
- Open surgery traditionally carries a higher risk of postoperative infections.
- Minimally invasive techniques offer potential advantages in reducing infection rates.
- Understanding these differences is crucial for optimizing patient outcomes.
Purpose of the Study:
- To compare postoperative infection rates between minimally invasive (laparoscopic) and open surgical procedures.
- To review the potential mechanisms contributing to observed differences in infection incidence.
- To synthesize current evidence on the impact of surgical approach on infection risk.
Main Methods:
- Systematic literature review of relevant studies.
- Analysis of randomized controlled trials (RCTs) and retrospective studies.
- Comparison of infection rates across common surgical procedures.
Main Results:
- Laparoscopic cholecystectomy showed lower incisional, urinary, and pulmonary infections (1.1% vs. 4%).
- Laparoscopic colorectal resection had reduced surgical site infections (5% vs. 9.5%) and less severe infections.
- Laparoscopic appendicitis surgery demonstrated lower surgical site (2% vs. 8%) and respiratory (0.3% vs. 3%) infections, but a higher intra-abdominal abscess rate.
Conclusions:
- Laparoscopic surgery is associated with significantly lower rates of postoperative infections compared to open surgery.
- Preserved immune function and reduced inflammatory response are key mechanisms.
- Minimally invasive approaches represent a significant advancement in reducing surgical site infections.
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