Physiology, Immunologic and Metabolic Responses to Laparoscopic Surgery

Laparoscopic surgery has become a widely accepted standard of care for various intra-abdominal procedures, particularly colectomy. The creation of pneumoperitoneum has the potential to alter normal homeostatic mechanisms, but in general alters physiology to a lesser degree than open surgery, which translates into improvements in postoperative recovery. In addition, there are important variations in the immunologic response to laparoscopic surgery in comparison with open surgery. While all the innumerable interactions that occur both at the local site of surgery and systemically are still being elucidated, it does seem that these differences may have implications in terms of oncologic outcomes.