The surgical trauma of abdominal wall incision - A comparison of laparoscopic vs open surgery with three-dimensional stereography

Background: Laparoscopic operations seem to respect the integrity of the ab dominal wall better than conventional laparotomy, but the effects of surgic al trauma are not well understood. The new technique of three-dimensional s tereography makes it possible to describe and calculate the mobility of the abdominal wall and the nature of the underlying disturbances. Methods: Three-dimensional stereography is a noninvasive optical method of measuring surface areas. Abdominal wall mobility can be assessed by compari ng changes to the abdominal surface in its minimum and maximum excursions. Different parameters, such as height difference and curvature, are calculat ed. We studied patients undergoing different types of surgical procedures ( laparoscopy and open surgery) by measuring their abdominal wall mobility be fore and after the procedure. We also compared these patients to a control group. Each group consisted of 30 patients, who were evaluated prospectivel y. Results: We found a significant difference in abdominal wall mobility betwe en patients treated via a laparoscopic approach, and those who had conventi onal surgery. At 7 days after laparoscopy, abdominal movement was always th e same in the laparoscopic group as in the controls. By contrast, the open surgery group still showed a significant lack of mobility 12 days after the procedure. Conclusion: The new method of three-dimensional stereography makes it possi ble to compare the trauma associated with different surgical approaches as it affects the integrity of the abdominal wall. As compared with open surge ry, laparoscopy has a significant positive effect on abdominal wall integri ty.