Abstract
Laparoscopic surgery may reduce the inflammatory response to surgery by the avoidance of a skin incision which is frequently the site of maximum tissue trauma. We hypothesized that the inflammatory response is less with minimally invasive procedures. The aim of this study was to evaluate the response of inflammatory mediators following laparoscopic and open hernia repair. Thirty-four patients undergoing unilateral primary inguinal hernia repair were prospectively assigned to either laparoscopic mesh hernia repair (n=14), open mesh hernia repair (n=11), or a Bassini repair (n=9). Serum samples withdrawn prior to surgery, 6 h after surgery, and then again at 24 h after surgery were assayed for interleukin-6 and C-reactive protein content. Interleukin-6 levels at 24 h in the laparoscopic (13.1±3.1 pg/ml), open mesh (15.5±2.5 pg/ml), or Bassini group (15.4±2.0 pg/ml) did not differ significantly. Neither did C-reactive protein levels at 24 h in the laparoscopic (12.4±2.7 pg/ml), open mesh (23.0±7.8 pg/ml), or Bassini group (18.6±6.6 pg/ml) differ significantly. The response of inflammatory mediators to hernia repair is not modified by undertaking the procedure laparoscopically.
Similar content being viewed by others
References
Attwood SEA, Hill ADK, Murphy PG, Thornton J, Stephens RB (1992) A prospective randomised trial of laparoscopic versus open appendicectomy. Surgery 112: 497–501
Brand MR, Fernandes A, Mordhorst R, Kehlet H (1978) Epidural analgesia improves postoperative nitrogen balance. BMJ 1: 1106–1108
Carey PD, Wakefield CH, Thayeb A, Monson JRT, Darzi A, Guillou PJ (1994) Effects of minimally invasive surgery on hypochlorous acid production by neutrophils. Br J Surg 81: 557–560
Castell JV, Andus T, Kunz D, Heinrich PC (1989) Interleukin-6, the major regulator of acute phase protein synthesis in man and rat. Ann N Y Acad Sci 557: 87–89
Corbitt JD (1991) Laparoscopic herniorrhaphy. Surg Laparosc Endosc 1: 23–25
Cruikshank AM, Fraser WD, Burns HJG, Van Damme J, Shenkin A (1990) Response of serum interleukin-6 in patients undergoing surgery of varying severity. Clin Sci 79: 161–165
Dinarello CA (1984) Interleukin-1. Rev Infect Dis 6:51–95
Gauldie J, Richards C, Harnish D, Lansdorp P, Baumann H (1987) Interferon β2/B cell stimulatory factor 2 shares identity with monocyte-derived hepatocyte-stimulating factor and regulates the major acute phase protein response in liver cells. Proc Natl Acad Sci 84: 7251–5
Grace PA, Quereshi A, Coleman J, Keane R, McEntee G, Broe P, Osborne H, Bouchler-Hages D (1991) Reduced postoperative hospitalization after laparoscopic cholecystectomy. Br J Surg 78: 160–162
Houssiau FA, Devogelaer JP, Van Damme J, Nagant de Deuxchaisnes C, Van Snick J (1988) Interleukin-6 in synovial fluid and serum of patients with rheumatoid arthritis and other inflammatory arthritides. Arthritis Rheum 31: 784–788
Joris J, Cigarini I, Legrand M, Jacquet N, De Groote D, Franchimont P, Lamy M (1992) Metabolic and respiratory changes after cholecystectomy performed via laparotomy or laparoscopy. Br J Anaesth 69: 341–345
Kushner I, Ganapathi M, Schultz D (1989) The acute phase response is mediated by heterogenous mechanisms. Ann NY Acad Sci 557: 19–30
Lichtenstein IL, Schulman AG, Amid PK (1989) The tension free hernioplasty. Am J Surg 157: 188–193
Mc Mahon AJ, O'Dwyer PJ, Cruikshank A, Mc Millan D, Lowe G, Rumley A, O'Reilly D, Baxter JN (1993) Metabolic changes after laparoscopic and minilaparoscopic cholecystectomy: a randomised trial. Br J Surg 80: 641
Mealy K, Gallagher H, Barry M, Lennon F, Traynor O, Hyland J (1992) Physiological and metabolic responses to open and laparoscopic cholecystectomy. Br J Surg 79: 1061–1064
Michie HR, Guillou PJ, Wilmore DW (1989) Tumour necrosis factor and bacterial sepsis. Br J Surg 76: 670–671
Monson JRT, Darzi A, Carey PD, Guillou PJ (1992) Prospective evaluation of laparoscopic-assisted colectomy in an unselected group of patients. Lancet 340: 831–833
The Southern Surgeons Club (1991) A prospective analysis of 1518 laparoscopic cholecystectomies. N Engl J Med 324: 1073–1078
Wilmore DW (1991) Catabolic illness—strategies for enhancing recovery. N Engl J Med 325: 695–702
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hill, A.D.K., Banwell, P.E., Darzi, A. et al. Inflammatory markers following laparoscopic and open hernia repair. Surg Endosc 9, 695–698 (1995). https://doi.org/10.1007/BF00187942
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00187942