Surgical Endoscopy

, Volume 7, Issue 5, pp 420–423

Changes in splanchnic blood flow and cardiovascular effects following peritoneal insufflation of carbon dioxide

Authors

  • Y. Ishizaki
    • Second Department of Surgery, Faculty of MedicineUniversity of Tokyo
  • Y. Bandai
    • Second Department of Surgery, Faculty of MedicineUniversity of Tokyo
  • K. Shimomura
    • Second Department of Surgery, Faculty of MedicineUniversity of Tokyo
  • H. Abe
    • Second Department of Surgery, Faculty of MedicineUniversity of Tokyo
  • Y. Ohtomo
    • Second Department of Surgery, Faculty of MedicineUniversity of Tokyo
  • Y. Idezuki
    • Second Department of Surgery, Faculty of MedicineUniversity of Tokyo
Original Articles

DOI: 10.1007/BF00311734

Cite this article as:
Ishizaki, Y., Bandai, Y., Shimomura, K. et al. Surg Endosc (1993) 7: 420. doi:10.1007/BF00311734

Summary

Laparoscopic surgery has rapidly become a popular and widely used technique. Although this procedure has been shown to be generally safe, cardiovascular derangement related to carbon dioxide pneumoperitoneum has been reported. There are few data available on the relationship between systemic and regional hemodynamics in cases of pneumoperitoneum. Changes in splanchnic blood flow and cardiovascular effects following a moderate increase of intraabdominal pressure (IAP) to 16 mmHg during a 3-h period were analyzed in six anesthetized dogs. After insufflation, cardiac output and blood flow in the superior mesenteric artery and portal vein decreased progressively and returned to the preinsufflation values following deflation. Hepatic arterial blood flow did not change significantly, perhaps due to compensatory mechanisms for maintenance of hepatic blood flow. Mechanical compression of the splanchnic capillary beds due to the elevated IAP may possibly reflect the increase in systemic vascular resistance causing the decrease in cardiac output. To prevent this impairment, intermittent decompression of gas during surgical laparoscopy is recommended.

Key words

Laparoscopic surgeryIntraabdominal pressurePneumoperitoneumCarbon dioxideCardiovascular responseSplanchnic blood flow

Copyright information

© Springer-Verlag New York Inc 1993