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Injury in laparoscopic surgery

J M Bolufer1, F Delgado, F Blanes

  • 1Department of General and Digestive Surgery, Peset Hospital, Valencia, Spain.

Surgical Laparoscopy & Endoscopy
|August 1, 1995
PubMed
Summary
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Laparoscopic surgery causes less neuroendocrine and metabolic response compared to open surgery. Specific complex laparoscopic procedures showed minimal neuroendocrine response, while inguinal hernioplasty had the least metabolic impact.

Area of Science:

  • Surgical Innovation
  • Physiological Response
  • Endocrinology

Background:

  • Minimally invasive surgery aims to reduce patient trauma.
  • Understanding the physiological stress response is crucial for surgical evaluation.

Purpose of the Study:

  • To compare the neuroendocrine and metabolic responses to laparoscopic versus open surgery.
  • To evaluate the extent of physiological injury associated with different surgical approaches.

Main Methods:

  • Prospective study comparing two patient groups: laparoscopic surgery (n=26) and open surgery (n=18).
  • Homogeneous groups based on age, sex, BMI, surgery duration, and anesthesia.
  • Measured plasma hormones (ACTH, GH, insulin, cortisol, FSH) and 24-h urine cortisol and catecholamines.

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Main Results:

  • Both groups showed increased ACTH, GH, insulin, and cortisol; decreased FSH and T3.
  • Open surgery (Group 2) exhibited higher 24-h urine cortisol and catecholamines.
  • Metabolic response was greater and correlated with duration in open surgery patients.

Conclusions:

  • Laparoscopic surgery generally results in a lower overall neuroendocrine and metabolic stress response than open surgery.
  • Complex laparoscopic procedures like sigmoid colectomy and esophagectomy showed the least neuroendocrine response.
  • Laparoscopic inguinal hernioplasty demonstrated the minimal metabolic response among procedures studied.