The impact of frailty on outcomes of minimally invasive laparoscopic surgery in elderly patients: a scoping review

Introduction. Aging is accompanied by a growing number of patients requiring surgical treatment, necessitating a reassessment of traditional approaches to preoperative risk stratification. In recent years, the concept of frailty has gained significant attention as a key factor influencing surgical outcomes. Frailty is characterized by a decline in physiological reserves, leading to an increased risk of postoperative complications, prolonged hospitalization, and impaired functional recovery. Methods. For this review, a systematic literature search and analysis were conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol, which includes a clear step-by-step procedure for identification, screening, eligibility assessment, and inclusion of relevant data. Publications indexed in the PubMed and eLibrary databases from 2012 to 2025 were analyzed. A total of 51 studies were included in the final analysis, of which 21 met the inclusion criteria: studies assessing the impact of frailty on the incidence of postoperative complications, length of hospital stay, mortality rates, and the need for rehabilitation in patients undergoing minimally invasive surgical procedures. The selection of publications was performed independently by two reviewers, and any disagreements were resolved through discussion with a third expert. Data from the included studies were systematized according to key outcomes and methods used to assess frailty. Results. A scoping review of the literature was conducted, summarizing data on surgical outcomes in frail patients undergoing minimally invasive procedures. The analysis confirms that patients with a high degree of frailty have a significantly increased risk of adverse outcomes, even in minimally invasive surgeries. However, modern frailty assessment tools allow for better risk prediction and adaptation of surgical strategies. While minimally invasive techniques demonstrate superior outcomes compared to open surgeries, they still require a personalized approach and enhanced perioperative monitoring. Conclusion. This review highlights the need for routine frailty screening in clinical practice to improve the safety of surgical treatment in elderly patients and optimize perioperative management strategies.