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Peritoneal Organ-Anatomical and Physiological Considerations

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Exploring Drug Delivery to the Peritoneum

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Abstract

Understanding the anatomy and physiology of the peritoneum has a direct effect on the outcome of medical therapy and laparoscopic surgery. The structural organization of the peritoneum, the characteristics of the peritoneal cavity, and the composition and extent of the contained peritoneal fluid pave the path for new discoveries in diagnostic strategies, drug delivery methodologies, and refinement of surgical procedures. The enormous surface area of the peritoneum, and the presence of interconnected greater and lesser peritoneal sacs and recesses in the upper and lower abdomen may render exploration of the extent of cancer dissemination a complicated process, but at the same time present the opportunity to devise effective therapeutic measures that counter inflammatory process and limit dissemination of cancerous cells. Knowledge of the topography, relationships of intra- and retroperitoneal organs, cytoarchitecture of mesothelial cells, and regional variations is likely to enhance focused therapy, reduce postoperative complications, hospital stay, and associated economic cost. Corollary to this, the size, distribution, and the chemical composition of the normal peritoneal fluid allow practitioners to rapidly correlate abnormal findings to disease processes. The nature and site of pain elicited by peritoneal irritation due to localized or generalized pathologic processes may be in the form of a sharp and well-defined or diffuse, dull, and aching pain depending on diseased peritoneal region and stimulated nerves. Hematogenous, lymphatic, or exudative contents of the peritoneal cavity may indicate traumatic injury or inflammatory process that presents rebound tenderness and rigidity.

Maintenance of homeostasis of the peritoneal cavity requires a stable chemical composition of the peritoneal fluid, an optimum temperature, and relative humidity. This way, viscosity of the peritoneal fluid hand and hypothermia are controlled by limiting evaporation and eliminating desiccation. Further, preserving this peritoneal milieu can eliminate cellular inflammation and stress, and reduce pain by blocking the release of immune reactive substances related to cell injury and disruption. In view of the above, preserving moisture on peritoneal surfaces during surgical procedures contributes to a normal physiologic setting and ultimately hastens patient’s recovery.

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  1. Department of Cellular Biology and Pharmacology, Florida International University Herbert Wertheim College of Medicine, Miami, FL, USA

    Orhan E. Arslan

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    Ranjita Shegokar

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Arslan, O.E. (2023). Peritoneal Organ-Anatomical and Physiological Considerations. In: Shegokar, R. (eds) Exploring Drug Delivery to the Peritoneum. Springer, Cham. https://doi.org/10.1007/978-3-031-31694-4_1

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