Is laparoscopic surgery beneficial and minimally invasive? How does the approach work and where does it lead?

Abstract

Since the first introduction of laparoscopic cholecystectomy, the field of laparoscopic surgery has expanded rapidly to include surgery for other organs, and more complex and technically demanding abdominal surgery. The reduced invasiveness of laparoscopic surgery is seen clinically in the rapid recovery and return to normal activities that results from reduced patient pain, destruction of the abdominal wall, and damage to organs and peritoneum when exposed to air. However, the exact procedure being performed in the abdominal cavity is sometimes a more important factor affecting the invasiveness of the surgery. Complicated and technically demanding procedures, which often increase the operation time and bleeding, and alter organ function, are sometimes more invasive by their nature, which diminishes the merits of laparoscopic surgery. For example, laparoscopic liver resections (LLR) under different settings have different results with or without the merits of laparoscopic surgery. In patients with hepatocellular carcinoma with the background chronic liver disease, LLR allows the surgeon to resect the tumor-bearing area with minimal damage to the liver and the surrounding environment, and to lower the risks of postoperative ascites and liver failure. However, these findings apply specifically to this setting and results differ for others. As indications expand, the true advantages and disadvantages of specific procedures in laparoscopic surgery should be reconsidered depending on the setting of each procedure.

Keywords

• laparoscopic surgery
• laparoscopic liver resection
• indication
• hepatocellular carcinoma
• chronic liver disease