Evidence Summary

What is an Evidence Summary?

Key messages from scientific research that's ready to be acted on

Got It, Hide this
  • Rating:

Abdominal laparoscopic surgery reduces surgical infections by 70-80% compared with open surgery in obese patients

Shabanzadeh DM, Sorensen LT. Laparoscopic surgery compared with open surgery decreases surgical site infection in obese patients: a systematic review and meta-analysis. Ann Surg. 2012;256:934-45.

Review question

What is the effect of laparoscopic surgery on surgical infections in obese patients?


Laparoscopic or minimally invasive surgery uses a lighted tube (laparoscope) with a tiny camera and specialized tools. The tube is inserted via small incisions (cuts) in the abdomen. Incisions are between 0.5 and 1.5 cm.

Traditional or open surgery uses larger incisions.

In general surgery, obesity increases the chances for surgical site infection.

For non-obese patients, laparoscopic surgery has fewer post-surgery complications and a shorter hospital stay than open surgery.

How the review was done

This summary is based on a systematic review of 8 randomized controlled trials and 36 observational studies of bariatric (weight-loss) and non-bariatric surgery.

RCTs included 615 obese patients. 7 studied weight-loss surgery and 1 appendix removal. They were published between 1999 and 2011.

Observational studies involved 58,755 patients. They included various surgeries: bariatric, hernia, gall bladder, appendix, colon and large bowel, and general. They were published between 1992 and 2011.

What the researchers found

Results from randomized controlled trials

  • Laparoscopic surgery reduced surgical site infections by about 80%.

Results from observational studies

  • Laparoscopic surgery reduced surgical site infections by about 70%.

Quality of evidence

  • All trials were high quality. However, none was designed expressly to assess differences in surgical site infections between laparoscopic and open surgery.
  • There was a large variation of treatment effects in the observational studies. The most typical flaw was a risk of selection bias.


Laparoscopic surgery in obese patients reduces infections in the surgical area by 70-80% compared with open surgery for general abdominal surgical procedures.

Related Topics


Observational studies
Studies where the treatment that each person receives is beyond the control of the researcher.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Selection bias
Possibility of errors in choosing individuals or groups to take part in a research study.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

Related Web Resources

  • Dementia in long-term care

    Canadian Institute for Health Information
    Older adults with dementia may need to move into long-term care homes if they can no longer stay at home. These people have higher risk of getting physically restrained or given antipsychotic medication. Changes to policy and education have made these things happen less often.
  • Treating pressure ulcers: New evidence, continued uncertainty

    Evidently Cochrane
    Gauze dressings should not be used to treat pressure ulcers (bed sores). Other options include alginate dressings, hydrogel dressings, and negative pressure wound therapy. More evidence is needed about which options are best to improve pain and reduce complications. Research should measure outcomes that matter to patients and carers as well as health professionals.
  • Patient education: Delirium (Beyond the Basics)

    UpToDate - patient information
    Delirium is the result of brain changes that lead to confusion, lack of focus and memory problems. There is no specific treatment for delirium - it is best to avoid risks, treat underlying illnesses and receive supportive care. Sedatives and physical restraints should be avoided.
DISCLAIMER These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Register for free access to all Professional content

Want the latest in aging research? Sign up for our email alerts.

Support for the Portal is largely provided by the Labarge Optimal Aging Initiative. AGE-WELL is a contributing partner. Help us to continue to provide direct and easy access to evidence-based information on health and social conditions to help you stay healthy, active and engaged as you grow older. Donate Today.

© 2012 - 2020 McMaster University | 1280 Main Street West | Hamilton, Ontario L8S4L8 | +1 905-525-9140 | Terms Of Use