title: Laparoscopic surgery and surgical infection.
abstract: BACKGROUND
  It has been observed that the metabolic response to surgical injury is less after laparoscopic surgery than after open surgery. However, the effect of laparoscopic surgery on surgical infection has not been given much attention in the surgical literature, even though it may decrease the incidence of infectious complications. The objective of this study was to assess the influence that laparoscopic surgery has on surgical infection and to highlight certain controversial aspects.
  
  
  METHODS
  A review of the literature was undertaken to examine the relationship between laparoscopic surgery and surgical infection. This was achieved primarily by using PubMed Medline as a source of material.
  
  
  CONCLUSIONS
  Laparoscopic surgery is associated with better preservation of the immune system than open surgery. This results in a decreased incidence of infectious complications. Although carbon dioxide pneumoperitoneum affects the peritoneal response to injury, it seems to have no harmful effect in terms of intra-abdominal infection. Nevertheless, at laparoscopic operation the virulence of intestinal micro-organisms should be recognized and, while knowing the advantages of minimally invasive surgery, the surgeon should consider the complexity of this technique. Furthermore, maintenance of laparoscopic instruments should be governed by the same norms as those used in open surgery; recommendations offered by the manufacturers should be respected.
authors.affiliation: Department of General Surgery, Hospital de Sant Pau and Hospital Clinic, Barcelona, Spain.
authors.forename: E M
authors.initials: EM
authors.lastname: Targarona
authors.forename: C
authors.initials: C
authors.lastname: Balagué
authors.forename: M M
authors.initials: MM
authors.lastname: Knook
authors.forename: M
authors.initials: M
authors.lastname: Trías
mesh_terms: D004866:Equipment Contamination; D006801:Humans; D007239:Infections / Q000209:etiology* / Q000276:immunology; D010535:Laparoscopy / Q000009:adverse effects*; D011027:Pneumoperitoneum; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects; D011312:Pressure; D013242:Sterilization