A New Parameter for the Evaluation of Laparoscopic Surgery: Quantitating Physical Activity as the Degree of Convalescence using an Accelerometer

Endoscopic surgery has rapidly become accepted as less invasive than other surgical procedures, but this has not been evaluated by objective parameters. Currently available parameters such as the day of first mobilization, the day of first food intake, or postoperative hospital stay are too subjective. To demonstrate that endoscopic surgery is actually less invasive, we compared physical activity for 7 days postoperatively measured by accelerometer in 3 groups of patients undergoing “less invasive” surgery (LMIN: laparoscopic cholecystectomy and laparoscopic partial gastrectomy), moderately invasive (ODG: open distal gastrectomy), and severely invasive (OTG: open total gastrectomy). Physical activity expressed as cumulative acceleration was more significant in the LMIN group than in ODG or OTG on each postoperative day. Recovery time defined as the day that cumulative acceleration recovered to 90% of the preoperative level, was shorter in the LMIN group than in ODG and OTG. Our results showed that the duration of convalescence differed with the degree of surgical stress and that measurement of physical activity using an accelerometer quantitatively evaluates the condition of convalescence after surgical stress.