Application Of Laparoscopy Research Articles

Application of laparoscopy to recurrent inguinal hernia in children

Objective To explore the value of laparoscopy in the diagnosis and treatment of recurrent inguinal hernia in children. Methods The clinical data of 67 cases receiving laparoscopic treatment for recurrent inguinal hernia in children at the Department of General Surgery, Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science & Technology were retrospectively analyzed, including the type of hernia recurrence, operation time, intraoperative and postoperative complications, such as short-term hydrocele formation and testicular atrophy and so on. Results In 67 cases, there were 65 males and 2 females.Open repair surgery and laparoscopic surgery were respectively performed in 48 cases and 19 cases for the first operation and the hernia defects were found after operation.Contralateral patent vaginal process deformities were found in 11 sides in the reoperation.Among 67 cases of recurrent inguinal hernia, incomplete ligation of hernia sac was found in 21 cases, low level ligation of hernia sac in 17 cases, no ligation of hernia sac in 14 cases, omissive direct inguinal hernia in 4 cases, loose ligation of hernia sac in 4 cases, overlarge inner ring in 4 cases, weak abdominal muscles in 2 cases, and increased abdominal pressure (long-term constipation, asthma) in 1 case.All the patients were treated by laparoscopic hernia repair and no serious complications occurred during the operation.The average time of unilateral operation was (15.0±2.2) minutes (13-25 minutes), and bilateral operation was (27.0±4.3) minutes (18-41 minutes). All patients were discharged on the second day.Two patients showed short-term postoperative hydrocele and were cured with conservative treatment.During the follow-up time of (23±2) months (9-39 months), no recurrence or testicular atrophy was found. Conclusions Laparoscopy can confirm the type of recurrent inguinal hernia and contribute to reduce postoperative recurrence.Laparoscopic management of recurrent inguinal hernia in children is safe and feasible, which is expected to replace open hernia repair. Key words: Laparoscopy; Recurrent inguinal hernia; Technical improvement; Child

Laparoscopic re-implantation of refluxing ureter in children: A feasibility study

ObjectiveTo report our initial experience in the application of laparoscopy in the management of children with unilateral vesico-ureteric reflux (VUR) using the laparoscopic extravesical transperitoneal approach following the Lich–Gregoir technique, and to evaluate the results and benefits of this technique for such patients. Patients and methodsBetween February 2013 and August 2014, 17 children [13 girls and four boys, with a median (range) age of 60 (24–120)months] presented with recurrent febrile urinary tract infections and were diagnosed with unilateral VUR. They underwent transperitoneal extravesical laparoscopic ureteric re-implantation following the Lich–Gregoir technique. Postoperatively abdomino-pelvic ultrasonography was done at 1month after surgery and voiding cystourethrography (VCUG) at 3months after surgery, and in cases with persistent VUR or de novo contralateral VUR another VCUG was done at 6months after surgery. ResultsThe median (range) operative time was 90 (80–120)min and the postoperative hospital stay was 2 (2–5)days. Intraoperative and postoperative complications were minimal. Patients were followed-up for a median (range) of 6 (3–21)months. All the children had complete resolution symptomatically and on VCUG, without further intervention. ConclusionsThe laparoscopic extravesical transperitoneal approach for ureteric re-implantation, following the Lich–Gregoir technique, is feasible and very effective in the management of VUR. Prospective randomised studies are eagerly awaited to define the benefits of this technique to patients, as well as to determine the cost-effectiveness of this approach.

Current situation and progress of Transanal total mesorectum excision

The concept of total mesorectal excision is an important change in the surgical treatment of rectal cancer. With the application of laparoscopy, laparoscopic total transductal mesorectal excision is becoming more and more concerned by the surgeon. Laparoscopic total transductal mesorectal excision may be a potential solution to the problem of low rectal cancer exposure and dissection in males with large tumors and small pelvic obesity. Not only to achieve the radical resection of rectal cancer requirements, but also to retain the anus as much as possible to avoid abdominal incision, the patient not only postoperative quality of life is improved, and beautiful. With the operation of equipment, surgical platform, technology constantly improvement, this procedure may play an important role in the____________ Key words: Transanal total mesorectal excision; Rectal neoplasms; Surgical procedures, minimally invasive; Review

Application of laparoscopy, endoscopy and laparoscopic and endoscopic cooperative surgery in gastrointestinal stromal tumors

Application of laparoscopy, endoscopy and laparoscopic and endoscopic cooperative surgery in gastrointestinal stromal tumors

Laparoscopic liver resection in patients with clinically significant cirrhosis: an Eastern perspective.

A sick heart can be revascularized, improving the health of the entire body. The function of a diseased kidney can be substituted by a dialysis machine. Just the act of cutting the abdominal wall can lead to death in a patient with underlying liver disease. And that the ducts and vessels of the liver are hidden from plain sight, have slowed the application of laparoscopy to liver surgery. As Dr. Blake Cady elegantly said nearly two decades ago: “Biology is King; selection of cases is Queen, and the technical details of surgical procedures are the Princes and Princesses of the realm who frequently try to overthrow the powerful forces of the King or Queen, usually to no long-term avail, although with some temporary apparent victories.” As commendable as the effort in pushing technical boundaries by the HPB surgical community is, we must not forget that these pursuits must translate to improving survival and quality of life. It just may be that laparoscopic liver resection (LLR) produces a greater balance between the king and the queen.

Application of laparoscopy in gastrointestinal abdominal emergency operation for patients over 65 years old

To explore the clinical application of laparoscopy in gastrointestinal abdominal emergency operation for patients over 65 years old. Clinical data of 138 cases (age>65 years) with acute abdomen undergoing laparoscopic surgery from January 2006 to June 2014 were analyzed retrospectively. Data of 170 cases treated by laparotomy during the same period were enrolled as controls. The laparoscopy group and the laparotomy group showed statistically significant differences in blood loss [(107.1±47.7) ml vs. (163.6±106.5) ml, P=0.000], postoperative complications rate [2.9%(4/138) vs. 12.9%(22/170), P=0.022], hospital stay [(10.5±7.5) d vs. (16.5±9.9) d, P=0.044], postoperative ambulation time [(25.6±7.7) h vs. (33.2±5.6) h, P=0.020], and recovery time of postoperative gastrointestinal function [(36.9±9.1) h vs. (49.3±10.6) h, P=0.031]. Patients with acute appendicitis, upper digestive tract perforation and bowel obstruction in the laparoscopy group were superior to those in the laparotomy group in hospital stay, postoperative ambulation time, recovery time of postoperative gastrointestinal function and intraoperative blood loss(all P<0.01), while no significant differences in colon perforation and mesentery diseases were found in hospital stay, intraoperative blood loss and recovery time of postoperative gastrointestinal function between the two groups (all P>0.05). Compared with laparotomy, the laparoscopy offers the advantages of less trauma, faster recovery, shorter hospital stay, and lower postoperative complications rate for patients over 65 years with acute abdomen.

Application of laparoscopy in the diagnosis and treatment of gastric cancer.

The advantages and feasibility of laparoscopic surgeries have been widely recognized in recent years. In China, most gastric cancer cases are already in their advanced stages. Thus, the rational application and promotion of laparoscopic surgeries have become one of the priorities in the management of gastric cancer. First, the roles of laproscopy in the diagnosis and efficacy evaluation of gastric cancer have not been fully recognized. While laparoscopic surgeries have been the standard treatment for the early gastric cancer, surgeons must have a solid knowledge of the indications of endoscopic and laparoscopic surgeries for the early gastric cancer and strictly obey them, so as to avoid excessive treatment. For patients with advanced gastric cancer, the laparoscopic surgeries still lack convincing evidences and require further validation in clinical trials. Currently, many studies on the laparoscopic surgeries for gastric cancer have been conducted in China; however, relevant training, access, and monitoring mechanisms still have not been established or applied. While the patients’ rights and interests should always be prioritized, the learning curves of laparoscopic surgeries as well as the indications of these surgeries for advanced gastric cancer are still problematic. Based on my personal training and experiences, I would like to share my understandings about the rational application of laporoscopy in the diagnosis and treatment of gastric cancer.

Application of laparoscopy in the combined surgical procedures of gynecological and digestive disorders in obese women: A retrospective cohort study

BackgroundLaparoscopy surgery has been widely used for many decades and combined laparoscopic procedures have become favorable choices for concomitant pathologies in the abdomen. However, the type of combination procedures and their safety in obese women have not been well elucidated in obese women. MethodsHere we retrospectively reported 147 obese women underwent combined laparoscopic gynecological surgery and cholecystectomy/appendicectomy in our hospital from January 2003 to December 2011. Of the total number of patients (n = 147), various laparoscopic gynecological surgeries were combined with laparoscopic cholecystectomy in 93 patients, and were combined with laparoscopic appendectomy in the rest 54 patients. Patients' ages ranged from 24 to 55 years with an average of 33 years. ResultsOur results showed that combined procedures caused various operative time and blood loss, with no difference considering the time to resume oral intake and length of hospital stay. Intraoperative complications occurred in a total of 7 patients (4.8%). None of the patients suffered from major complications after laparoscopic surgery, and minor postoperative complications occurred in 30 patients (20.4%). The follow-up period ranged from 6 to 24 months (average, 18.5 months). None of the patients developed complications during follow-up, except that one patient suffered from colporrhagia. ConclusionsOur results further suggest that the combined abdominal laparoscopic procedures of gynecologic and general surgery are safe and economic choices for obese women, and benefit patients in many ways including lesser pain, shorter hospital stays and earlier recovery.

Core value of laparoscopic colorectal surgery.

Since laparoscopy was first used in cholecystectomy in 1987, it has developed quickly and has been used in most fields of traditional surgery. People have now accepted its advantages like small incision, quick recovery, light pain, beauty and short hospital stays. In early times, there are still controversies about the application of laparoscopy in malignant tumor treatments, especially about the problems of oncology efficacy, incision implantation and operation security. However, these concerns have been fully eliminated by evidences on the basis of evidence-basis medicine. In recent years, new minimally invasive technologies are appearing continually, but they still have challenges and may increase the difficulties of radical dissection and the risks of potential complications, so they are confined to benign or early malignant tumors. The core value of the laparoscopic technique is to ensure the high quality of tumor's radical resection and less complications. On the basis of this, it is allowed to pursue more minimally invasive techniques. Since the development of laparoscopic colorectal surgery is rapid and unceasing, we have reasons to believe that laparoscopic surgery will become gold standard for colorectal surgery in the near future.

Application of laparoscopy in the diagnosis and treatment of neonates and infants with congenital intestinal atresia and stenosis

To investigate the feasibility and efficacy of laparoscopic procedure in the diagnosis and treatment of congenital intestinal atresia and stenosis in neonates and infants. Between September 2009 and September 2013, 55 cases with intestinal atresia and stenosis underwent laparoscope-assisted procedures in our department. There were, 32 males and 23 females, Twelve cases were diagnosed as duodenal atresia and stenosis and 43 as intestinal atresia and stenosis. The age at hospitalization was 7 minutes to 7 months(mean 9.88 d). After the diagnosis by multiport or transumbilical single-site laparoscopic exploration, cases with duodenal atresia and stenosis and part of the cases with proximal jejunum were treated by laparoscopic operations to remove the septum and restore intestinal continuity. In other cases with intestinal atresia and stenosis, laparoscopic inspection was performed to make diagnosis and then the proximal and distal ends of the atresia were exteriorized through the umbilical port site for end-to-oblique anastomosis. All the 55 cases underwent this minimally invasive approach, and no case was converted to open surgery. The operative time of laparoscopic procedure for duodenal atresia and stenosis (n=12) ranged from 80 to 145 min(mean, 110 min). During the follow-up of 3-34 months, one case had recurrent postoperative vomiting induced by giant duodenal expansion above anastomotic stoma and died the second day after operation. The operative time of laparoscopic surgery for intestinal atresia and stenosis (n=43) ranged from 35 to 70 min (mean 46 min). During the follow-up of 3-36 months, 3 cases complicated with meconium peritonitis had postoperative short bowel syndrome and died. One case died of intestinal perforation at 3 month postoperatively. One case died of intestinal adhesion at 7 month postoperatively. The rest of cases had favorable outcomes. Laparoscopic surgery for the diagnosis and treatment of intestinal atresia and stenosis has advantages of small incision, less trauma, and rapid recovery.

Trends in laparoscopic surgery for hysterectomy in Korea between 2007 and 2009.

The aims of this study are to estimate the hysterectomy rate for benign disease and determine recent trends in laparoscopic surgery for hysterectomies, including subtotal, total, and radical hysterectomy, in Korea. Computerized discharge summaries from private and public hospitals for 2007-2009 were obtained from the Health Insurance Review & Assessment Service. All records listing subtotal and total hysterectomies for benign disease and radical hysterectomies in women aged ≥ 16 years in each period were selected (n = 99,388). All women living in Korea aged ≥ 16 years were the denominator population. Laparoscopic surgery was identified when the code for laparoscopic materials was used. Statistical analysis included a trend test. The hysterectomy rates for benign disease were 1.48, 1.49, and 1.52/1000 women aged ≥ 16 years in 2007, 2008, and 2009, respectively, and the overall rate was 1.49/1000 women. The trend increased (P for trend <0.001). The use of laparoscopy for subtotal and total hysterectomies accounted for 43.1% in 2007, 47.7% in 2008, and 52.0% in 2009, which showed a clear increasing trend (P for trend <0.001). The use of laparoscopy for radical hysterectomies comprised 26.7%, 28.7%, and 38.2% of cases in 2007, 2008, and 2009, respectively, an increased trend (P for trend <0.001). The hysterectomy rate for benign disease increased between 2007 and 2009 in Korea. Application of laparoscopy during subtotal, total, and radical hysterectomies has increased significantly.

Application of laparoscopy combined with C-arm machine in the diagnosis and treatment of abdominal ectopic intrauterine device

Objective To investigate the application of laparoscopy combined with C-arm machine in the diagnosis and treatment of abdominal ectopic intrauterine device (IUD).Method From December 2005 to December 2013 in our hospital 10 cases of ectopic IUD in abdominal cavity with the diagnosis and treatment were analyzed retrospectively.Result The surgery for 10 patients to remove ectopic IUD under the laparoscopy were successful by the C-arm to help locate.Conclusions For the complex situation diagnosed with abdominal ectopic IUD but not clear ectopic sites,accurate positioning is a guarantee of successful operation.Laparoscopy combined with C-arm machine surgery to remove the abdominal ectopic IUD is minimally invasive,intuitive,accurate,safe,effective,etc.Good clinical results obtained. Key words: Laparoscopy; C-arm machine; Intrauterine device; Ectopia

Application of laparoscopy in the modified nerve plane-sparing radical hysterectomy of cervical cancer

The aim of this study was to assess the feasibility and safety of laparoscopic nerve plane-sparing radical hysterectomy (NPSRH) and compare with that of open NPSRH. One hundred and thirty-four patients with FIGO stage Ib1-IIa2 cervical cancer were enrolled in the study. Thirty-three patients underwent laparoscopic NPSRH. During the operation, the pelvic autonomic nerve plane which is directly underneath the ureter was integrally preserved by dissecting the pelvic spaces laparoscopically. The vessels around the nerve plane were controlled by Hem-o-lok polymer clips. One hundred and one patients underwent open NPSRH without special instruments. The clinical, pathological and surgery-related parameters were compared between the two groups. Moreover, postoperative short-term bladder function of these patients was also analyzed. There was no significant difference between the laparoscopic group and open group in terms of age, body mass index, previous surgery, FIGO stage, pathologic type, etc. (P > 0.05). The mean duration of surgery in the laparoscopic group was significantly longer [(303.8 ± 67.5) min vs. (272.4 ± 57.5) min] (P < 0.01). But, the laparoscopic group had less blood loss [177.0 ml vs. 474.5 ml, P < 0.01] and blood transfusion rate [ 6.1% (2/33 cases) vs. 49.5% (50/101 cases), P < 0.001]. There was no significant difference regarding the proportion of patients who firstly passed the post-void residual urine volume (PVR) test (P > 0.05). The median time of catheterization between the two groups were also comparable (P > 0.05). However, the postoperative hospital stay was significantly shorter in the laparoscopic group [median postoperative hospital stay 9.2 days vs. 11.0 days, P < 0.001]. Laparoscopic NPSRH is feasible. It seems to be comparable with open NPSRH in terms of preserving pelvic nerve function, but is more favorable in terms of blood loss and postoperative recovery.

Laparoscopic Neuromapping in Pelvic Surgery

New developments in intraoperative electrophysiological neuromonitoring for conventional surgery are providing further insights into functional neuroanatomy and nerve-sparing in the minor pelvis. The aim of this study was to open up potential scopes of application in laparoscopy. Ten patients with different indications for surgery (presacral tumor excision, n = 2; resection rectopexy. n = 2; low anterior rectal resection, n = 2; proctocolectomy. n = 2; abdomino-perineal excision of the rectum, n = 2) were investigated prospectively. The pelvic autonomic nerves were bilaterally mapped by laparoscopic electric stimulation under simultaneous electromyography of the internal anal sphincter and manometry of the bladder. Stimulation results were compared to patients' anorectal and urogenital functional outcome. In all the operations laparoscopic neuromapping (LNM) was technically feasible. Laparoscopy enabled excellent visibility of pelvic neural structures for simple and differentiated electric stimulation. In all cases LNM resulted in significantly evoked electromyographic potentials and intravesical pressure rises. The technique facilitated electrophysiological determination of functional neuroanatomical topography in the minor pelvis. The stimulation results were suitable to confirm laparoscopic nerve-sparing and compatible with patients' anorectal and urogenital functional outcome. LNM is technically feasible and opens up a new dimension for verification of functional nerve integrity. Further developments and investigations are mandatory to evaluate its role for laparoscopic nerve-sparing procedures.

A new classification of duplex kidney based on kidney morphology and management

Background The initial classic classification of duplex kidney into complete (two ureters) and incomplete (“Y” shaped ureter) types are based on the ureter status. At the meantime, the features of the upper and lower moieties of duplex kidney were very crucial for appropriate procedure of hemi-nephrectomy, which was most commonly used for addressing the issues caused by a duplex kidney; and recently more applications of laparoscopy were used. In this study, we aimed prudently to propose a new classification based on the features of the upper and lower moieties of duplex kidney. Methods Sixty-five children with 83 duplex kidneys were reviewed retrospectively. Based on kidney morphology found in CT urography and surgical findings, duplex kidney was classified into five types. Results The first was the appendant type (36/83) and its feature was that the mini upper moiety was located on top of the lower one, with a visualized shallow groove between them. The ureter was dilated with an ectopic orifice or ureterocele. The second was the embedded type (13/83), the feature of which was that mini upper moiety located in the interior top of the lower one within the same capsule. The upper ureter was dilated with an ectopic orifice or ureterocele. The third was the hydronephrosis type (12/83). The severe hydronephrotic upper moiety was almost as big as the lower moiety. The upper ureter was severely dilated and circuitous with an ectopic orifice. The forth was the dual-poor type (2/83). The two moieties were all very small with “Y” shaped ureters and ectopic orifices. The last was the dual-well type (20/83). The upper moiety was almost the same size as the lower one, without apparent dilation of “Y” shaped or double ureters. Conclusion Based on kidney morphology, duplex kidney can be mainly classified into five types which can be depicted by CT urography prior to management and can provide an aid in selecting a successful course of surgical correction.

The application of laparoscopy in abdominal trauma at Al-Jumhoori Teaching Hospital in Mosul

Objective: To evaluate laparoscopy as a diagnostic and therapeutic method in selected cases in abdominal trauma, and its value in avoiding unnecessary laparotomies at Al-Jumhoori Teaching Hospital in Mosul, Iraq. Patients and methods: From October 2009 to October 2011, sixty hemodynamically stable patients who were admitted with abdominal trauma (48 blunt, and 12 penetrating injuries), were submitted to diagnostic laparoscopy (DL) in the operating theatre of the Emergency Department of Al-Jumhoori Teaching Hospital in Mosul. Data collected and analyzed. Results: Negative and non therapeutic laparotomies were avoided in 38 patients (63.3%), and laparoscopic intervention was done in 4 patients (17.4%). The mean hospital stay of the (DL) negative patients was 2.1 days, and for the (DL) positive patients with laparoscopic intervention was 2.4 days, while of the patients with therapeutic laparotomy was 5.7 days. All the patients were discharged with no reported complication and no deaths were reported. Conclusion: Laparoscopy can be performed safely and effectively in hemodynamically stable patients with abdominal trauma. The most important advantages are reduction of the negative and non therapeutic laparotomy rate and shortening of hospitalization. Keywords: Blunt abdominal trauma, penetrating abdominal trauma, diagnostic laparoscopy.

THE PLACE FOR LAPAROSCOPICALLY SURGERY IN THE TREATMENT OF ENDOMETRIAL CANCER (survey)

In the treatment of endometrial cancer, which is been the most frequently met oncogynecological disease, basic method remains surgical. Putting into gynecological practice of highly technological operations contributed to the active application of laparoscopy in the treatment of the malignant new formations of endometrium

Real-time infrared thermography for ureter detection during hysterectomy

BackgroundRecognition of different anatomic structures might be difficult in the presence of diseases such as neoplasm or endometriosis that can subvert the anatomy. This can be a challenge for young surgeons approaching gynecologic surgery. The aim of the present study was to evaluate the effectiveness of infrared thermocamera to identify the anatomic structures in gynecologic surgery. Materials and methodsFrom February 2010 to May 2011, consecutive patients who required abdominal hysterectomy were considered for eligibility. During a procedure for benign disease, we evaluated the temperature difference between the ureter and infundibulopelvic vessel (experiment A). In patients with gynecologic cancer, the thermal gradient was determined between the iliac vessels and the ureter (experiment B). ResultsThe data from 21 patients were recorded, 12 for experiment A and 9 for experiment B. We found a statistically significant difference between the ureter and vessels in both experiments (31.675°C ± 0.673°C for the ureter and 33.332°C ± 0.828°C for the infundibulopelvic vessel, P < 0.0001; 31.706°C ± 0.751°C for the ureter, 33.787°C ± 0.63°C for the iliac vein, and 33.784°C ± 0.639°C for the iliac artery, P < 0.0001). ConclusionsInfrared imaging allowed us to identify the anatomic structures in laparotomy, providing preliminary data for its application in laparoscopy.

Laparoscopic gastrectomy for gastric adenocarcinoma: A single institution’s experience and oncologic outcomes of 65 consecutive patients.

79 Background: The application of laparoscopy in the surgical treatment of gastric cancer has become more commonly utilized in recent years. Most of the published series are from Asia and few report on survival. Our objective was to elucidate the safety, efficacy, and oncologic outcomes of laparoscopic gastrectomy in patients with gastric adenocarcinoma. Methods: The medical records of all patients who underwent laparoscopic gastrectomy at City of Hope National Medical Center between 6/2005 and 8/2011 were retrospectively reviewed. Relevant data analyzed included patient demographics, operative parameters, complications, recurrence, and survival. Results: A total of 65 consecutive patients were identified. Of all laparoscopic procedures, 5 were proximal, 41 were distal, and 19 were total gastrectomies. Median age was 67 years (35-96). Median operative time was 370 min (228-583). Median EBL was 200 ml (10-900). Twenty-eight of the 65 laparoscopic gastrectomy cases employed robotic assistance in lymph node dissection. The median number of lymph nodes retrieved was 26. Forty-seven cases included D2 lymph node dissections, 16 cases were D1 dissections, and 2 cases involved D0 dissections. All intended D2 dissections had greater than 15 nodes retrieved. Median hospital stay was 7 days (3-39). Morbidity and mortality rates were 33% and 3%, respectively. Histological staging revealed most patients with Stage I or II disease. Median follow-up was 15 months (0.5 to 58). Cancer has recurred in 4 patients (6%). The 3-year overall survival for stage I disease (N=38) is 92%, stage II disease (N=17) is 71%, and for stage III (N=7) is 51%. Conclusions: The long-term oncologic outcomes and overall survival are comparable to that of open technique seen in other series. Our large institutional series shows that laparoscopic gastrectomy for gastric adenocarcinoma is feasible and safe and can be performed in patients with gastric cancer with excellent surgical and oncologic outcomes.

Laparoscopic Preconditioning Protects Against Oxidative Injury in Cerulein-Induced Pancreatitis Rats (An Experimental Study)

Laparoscopic cholecystectomy, particularly in the same hospital stay, has been widely recommended to treat gallstone-pancreatitis over the last decade. Although pancreatitis produces severe oxidative injury, laparoscopy exerts an additional effect over that is produced by pancreatitis. The preconditioning phenomenon previously reported as protective in open surgery is a beneficial maneuver also in laparoscopic surgery. So in the present study we have tried to find out the effect of laparoscopic preconditioning over the pancreatitis in cerulein-induced pancreatitis rats. Acute pancreatitis was induced in 24 rats weighing between 280 and 350 g by three subcutaneous injection of 80 μg/kg of body weight cerulein. A 1-cm midline laparotomy was performed for all rats, and then they were randomly assigned to one of the following three groups (n=8 for each): Group I (control), Group II (laparoscopy), and Group III (laparoscopic preconditioning [L-Pre]). After that, a catheter was placed into the peritoneum for the creation of the pneumoperitoneum (Pp) in all the animals except the control group. The rats of Groups II and III were subjected to 60 minutes of Pp with 15 mm Hg intraabdominal pressure followed by 30 minutes of deflation. The L-Pre procedure was applied to Group III immediately before the laparoscopic procedure. Blood samples were taken for biochemical assays. Pancreas tissue samples were taken for light microscope analysis. The light microscopy of the pancreas tissues revealed that cerulein injection caused edema and sparse inflammatory cell infiltration mimicking the edematous pancreatitis. However, the application of laparoscopy over the pancreatitis produced significant inflammatory cell infiltration, acinus vacuolization, and necrosis (in one case) in addition to edema. But, the laparoscopic preconditioning maneuver applied before the laparoscopy significantly decreased in particular acinary vacuolization and cell infiltration. Therefore the total sum of the histopathological score of the L-Pre group was significantly less than that of the laparoscopy group. The biochemical analysis of the groups revealed that laparoscopy caused significant elevation of malondialdehyde levels and decrease of reduced glutathione values. However, the addition of preceding preconditioning produced significant amelioration of these parameters. Laparoscopic preconditioning may be a useful method to decrease the oxidative injury in cases undergoing cholecystectomy for biliary pancreatitis. But, it should be emphasized that this was a restricted experimental study, and further clinical studies are needed to adopt these results into clinical settings.