Impact of laparoscopic surgery on immune function.

OBJECTIVES: Endoscopic surgery, mostly studied during laparoscopic hysterectomy or cholecystectomy, has no important effects on classic endocrine responses when compared with similar open operations but may slightly reduce inflammatory responses and various immune functions. Preservation of both systemic and intraperitoneal immunity is particularly important in surgery for intra-abdominal sepsis or cancer and thus an understanding of the impact of laparoscopy on immune function is relevant. METHODS: Substantial recent studies on the topic of immune response in general and gynecologic surgery were identified from Medline. RESULTS AND DISCUSSION: The impact of laparoscopic surgery on the peri- and postoperative metabolic and systemic immune response is significantly less after laparoscopic hysterectomy or cholecystectomy than with an open approach. CONCLUSION: Laparoscopic surgery better preserves the postoperative immunological functions. However, prospective randomized studies are necessary to see whether these potential advantages can be employed in common clinical practice.