Since the advent of diagnostic laparoscopy in the 1960s, laparoscopic surgery has been practiced. Beginning in the 1980s. Since then, it has become a widely used method for a variety of purposes. For several organ systems, including the digestive and reproductive (especially gynecological), the treatment has emerged as the gold standard (as for cholecystectomy). Laparoscopic surgery has become safe and practical across a variety of medical specialties thanks to significant advancements in surgical training, tools, imaging, and surgical procedures.

Appendectomy

Laparoscopic surgery obviously has an advantage over open appendectomy, as demonstrated by systematic reviews and meta-analyses that examined the clinical outcomes. It has been established that laparoscopic appendectomy is a safe and practical surgery for treating acute appendicitis and even complex appendicitis. Laparoscopic appendectomy proponents assert that in addition to providing a more accurate diagnosis, the technique also reduces wound infections, causes less pain, has a quicker recovery time, and allows patients to return to work sooner. On the other hand, laparoscopic surgery appears to take longer than open surgery. The laparoscopic group was found to have a higher incidence of intra-abdominal abscess in earlier investigations, but later reviews found no discernible differences between laparoscopic and open surgery.

In comparison to the open appendectomy group, the outcome parameters, wound infection rate, and overall postoperative complication rate were all significantly lower in the obese patients. The length of the procedure did extend, most likely as a result of the technical difficulties presented by patients with BMIs more than 30 kg/m2. Despite this, for the treatment of appendectomy in obese patients, the benefits of the laparoscopic technique exceed the drawbacks.

Pregnant patients have a higher chance of fetal loss (although there is little evidence for this) and a slightly higher rate of preterm labor, which is not clinically relevant.

Cholecystectomy

When compared to patients who underwent open surgery, patients who underwent laparoscopic cholecystectomy did not significantly differ in terms of morbidity or mortality. They actually recovered more quickly and spent less time in the hospital. The authors believe that the minimalized open procedure is a practical and secure alternative for healthcare providers without the funding for laparoscopic equipment and without qualified, trained surgeons, even though mini-laparotomy had a similar overall result. Later research revealed no difference in morbidity and mortality between laparoscopic, minimally invasive, and traditional open surgery.

Laparoscopic cholecystectomy has been demonstrated to be a safe and practical procedure; it outperforms open surgery in terms of cardiac and respiratory problems in older patients.

Esophageal surgery

It is technically difficult to do minimally invasive surgery for esophageal cancer, and the wide range of surgical approaches makes it challenging to understand the results and discoveries published in the present literature. Numerous research only involves a limited number of participants, and there are no randomized controlled trials to support the findings.

Esophageal cancer patients who had laparoscopy had lengthier surgeries, less blood loss, shorter stays in the hospital, and lower overall morbidity.

Lack of terminology for postoperative problems or surgical methods was one of the challenges in comparing findings among studies. Many studies did not perform or describe a radical lymphadenectomy, and the minimal number of lymph nodes harvested was not reached. Other research has discovered a comparable lymph node harvest or even more lymph nodes in laparoscopic treatment compared with open surgery.Similar to open surgery, laparoscopy has been associated with mild difficulties, although the major complications were considerably reduced in the laparoscopic group. The lymph node harvest had no effect on the survival rate, even in the case of the long-term outcomes, as the smaller number of harvested lymph nodes revealed a similar percentage of positive lymph nodes. Patients undergoing minimally invasive surgery with an adequate lymph node harvest and a comparable oncological result experienced better short-term and long-term outcomes after a reported surgical method alteration (the “Ivor Lewis approach”).

Patients who have laparoscopic surgery generally benefit from less access trauma, less pain, an accelerated postoperative recovery of bowel function, a quicker return to activity, and superior cosmetic results. Finding proof of putative advantages like less adhesions and incisional hernias was challenging.

Reflux surgery

The laparoscopic method has emerged as the gold standard for the surgical treatment of gastroesophageal reflux disease (GERD). Compared to open surgery, laparoscopic surgery for the treatment of GERD resulted in a shorter hospital stay, a quicker recovery, a quicker return to normal activity, and a considerable decrease in perioperative morbidity. Patients who underwent laparoscopy reported a higher quality of life than those who underwent other medical procedures like proton-pump inhibitor medication therapy alone. Laparoscopy has been demonstrated to more effectively address symptoms, such as reducing heartburn and regurgitation.

Gastric surgery

A difficult operation is laparoscopic stomach surgery. The stage of the gastric tumor (early vs. advanced), whether a partial or total gastrectomy was performed, and the presence of gastrointestinal stromal tumors all affect the surgery’s outcomes (GIST). With reduced blood loss, a shorter hospital stay, quicker bowel healing (shorter time to first flatus), and fewer significant perioperative complications, laparoscopic resections have a superior overall short-term result. The average length of the surgery, though, was lengthier. Infections at the surgery site and complications from wounds were less severe in the laparoscopic group. There was no difference between laparoscopic and open surgery for severe postoperative sequelae like anastomotic leakage, stenosis, hemorrhage, and postoperative ileus.

Colorectal surgery

Laparoscopic colorectal surgery is a well-recognized safe operation, however it must be distinguished from surgically treating benign from malignant disease. A survey of recent literature demonstrates a continual learning curve and development in the management of postoperative care, including the creation of concepts and methods for “improved recovery after surgery” (ERAS). For patients undergoing colorectal surgery, the combination of the surgical techniques (minimally invasive access) lowering major morbidities and standardized postoperative therapy approaches resulted in a positive outcome. Laparoscopic surgery within a multimodal rehabilitation programme resulted in the shortest hospital stay and lowest morbidity for colorectal cancer patients.

Rectal cancer

Laparoscopic surgery for rectal cancer has the advantage of requiring little access. Following the laparoscopic procedure, there was a considerably reduced amount of blood loss, time before the first bowel movement, oral fluid consumption, and wound infection in the laparoscopic group. Regarding complications like ureter injury, urinary retention, ileus, anastomotic leakage, or an incisional hernia, there were no differences between the laparoscopic technique and the open operation. Long-term and short-term oncological outcomes, such as specimen length, circumferential resection margin, local recurrence, port/wound metastasis, and distant metastasis, also did not differ significantly from one another. The two therapies had comparable three-, five-, and ten-year disease-free and overall survival rates.

Liver surgery

Treatment for primary hepatocellular carcinoma or colorectal cancer metastases typically involves laparoscopic liver resection. There are very few other reasons, such cyst resection. Patients with limited illness, such as those with isolated findings of 3–4 liver metastases, frequently undergo minimally invasive procedures. Segments VII, VIII, and IVa are challenging to reach, therefore findings in segments II–IV of the liver are better suited for a laparoscopic approach. An intraoperative ultrasound and comprehensive preoperative imaging are beneficial.

Shorter postoperative hospital stays, decreased rates of positive resection margins, fewer perioperative problems are just a few of the benefits of laparoscopic liver resection for short-term outcomes. Some of the observed results may have been impacted by patient selection.