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Background: Cytokines are the main mediators of inflammation and the response to trauma. The purpose of this study was to compare variations in cytokine levels following laparoscopic cholecystectomy (LC) and minilaparotomy cholecystectomy (OC), since these two types of operations were considered to be a unique model for examining the role of local tissue injury in postoperative inflammatory reactions. Methods: A total of 40 patients were studied. Eighteen of them underwent LC; the remaining 22 were operated on using the open technique. Systemic concentrations of interleukin- 6 (IL-6), interleukin-1 (IL-1), tumor necrosis factor (TNF), and C-reactive protein (CRP) were measured before and after the operation. In addition, we compared pre- and postoperative white blood cell (WBC) counts, postoperative body temperature, and length of postoperative hospitalization. Results: There was no difference between the two groups in IL-1 and TNF response. The rise in plasma IL-6 levels (18.86 ± 9.61 vs 5.00 ± 0.0 pg/ml, p< 0.0001) and CRP (8.40 ± 5.81 vs 1.43 ± 1.30 mg/dl, p< 0.001) were more marked after open cholecystectomy than after the laparoscopic procedure. There was no correlation between serum CRP concentrations and the other postoperative parameters. Conclusion: The magnitude of the acute-phase response was less pronounced following laparoscopic cholecystectomy, consistent with a reduction in tissue trauma.

Abstract: Background: Minimally invasive video-assisted thyroidectomy and paratiroidectomy (MIVAT/P) are surgical procedures performed with 5-mm cameras handled by a camera assistant. Methods: The authors created a new camera handler for video-assisted neck surgery. It consists of a telescopic tripod device designed for mechanical handling of the camera, which is directly oriented by the operator even in solo surgery procedures. The camera is placed inside an O-shaped support, and moved by the operator himself for exploration and work on the surgical field. Results: Thanks to this simple device, the camera holder provides a firm field and prevents blood stains in limited working spaces. Conclusions: The novel camera handler may be useful in either MIVAT/P or other simple laparoscopic procedures (i.e., cholecystectomy) for a steady handling of the camera, even in solo surgery procedures.