Metabolic response to abdominal surgery: the 2-wound model.

An abdominal operation combines a somatic abdominal wall wound with a second autonomic wound to the peritoneal cavity and viscera and little attention has been paid the autonomic/peritoneal wound that communicates directly to the brain by the vagus nerve. Moreover, vagal input originating from the peritoneum modulates and regulates postoperative recovery. Consequently, blockade of the afferent neural and inflammatory input from this autonomic/peritoneal wound will reduce postoperative neurohormonal stress and enhance patient recovery from an abdominal operation.