Laparoscopic cholecystectomy: a minor abdominal trauma?

Clinical observations following laparoscopic surgery indicate a shorter period of postoperative ileus than after conventional surgery. The aim of our study was to verify disorders of postoperative motility of the small intestine by means of implanted electrodes after laparoscopic and conventional cholecystectomy (CHE) in an animal model. Four weeks after implantation of three electrodes on the jejunum, CHE was performed laparoscopically in 5 dogs and in an additional 5 dogs by laparotomy. Independent of the type of operation, normal motility (especially the migrating motility complex) was abolished during the early postoperative period. Electrical activity was characterized by the basic electrical rhythm. Time to the occurrence of the first postoperative activity front, indicating restoration of motility, varied significantly depending on the type of operation: It was 5.5 +/- 1.0 hours after laparoscopic CHE and 46 +/- 5 hours after conventional CHE. These results support the hypothesis that small peritoneal incisions and less manipulation of the intestine during laparoscopic surgery result in reduced abdominal trauma.