Review ArticlesMinimally Invasive Surgery and Oxidative Stress Response What Have We Learned From Animal Studies?Yiannakopoulou, Eugenia MD, MSc, PhD*; Nikiteas, Nikolaos MD, PhD†; Perrea, Despina PhD‡; Tsigris, Christos MD, PhD§Author Information *Faculty of Health and Caring Professions, Technological Educational Institute of Athens †2nd Department of Propedeutic Surgery School of Medicine ‡Laboratory for Experimental Surgery and Surgical Research §1st Department of Surgery School of Medicine, NKUA, Athens, Greece Part of this article has been presented as an oral presentation in NESA (New European Surgical Academy), Athens, 2009. The authors declare no conflicts of interest. Reprints: Eugenia Yiannakopoulou, MD, MSc, PhD, Faculty of Health and Caring Professions, Technological Educational Institute of Athens, Eleutheriou Benizelou 106, Kallithea 17676, Athens, Greece (e-mail: [email protected]). Received February 13, 2012 Accepted September 15, 2012 Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: February 2013 - Volume 23 - Issue 1 - p 25-28 doi: 10.1097/SLE.0b013e318278cf5f Buy Metrics Abstract Oxidative stress (OS) is an integral part of the surgical stress response. Minimally invasive surgery causes less trauma, and thus attenuated stress response is anticipated. However, the pneumoperitoneum or pneumoretroperitoneum is implicated in free radical production. This study reviewed available data on the impact of minimally invasive surgery on OS response of animal models in a systematic way. Databases were searched up to and including January 2010. Most of the studies investigated the effect of pneumoperitoneum on OS, 3 studies investigated the effect of pneumoretroperitoneum on OS. There was a great heterogeneity on experimental conditions including animal models, measured OS markers, methods, and time periods of measurement. Published animal data do not allow a reliable conclusion on the effect of minimally invasive surgery on OS because of the great heterogeneity of experimental conditions. Besides, most studies focus on the effect of pneumoperitoneum, without taking into consideration the effect of less surgical trauma. © 2013 Lippincott Williams & Wilkins, Inc.