World Journal of Surgery

, Volume 24, Issue 10, pp 1227–1231

Influence of Gases on Intraperitoneal Immunity during Laparoscopy in Tumor-bearing Rats

  • Susan J. Neuhaus
  • David I. Watson
  • Tanya Ellis
  • Allan M. Rofe
  • George Mathew
  • Glyn G. Jamieson
Article

DOI: 10.1007/s002680010242

Cite this article as:
Neuhaus, S., Watson, D., Ellis, T. et al. World J. Surg. (2000) 24: 1227. doi:10.1007/s002680010242

Abstract.

Laparoscopy has been associated with metastases to abdominal wall wounds. In addition, many recent experimental studies suggest that laparoscopy is associated with increased tumor dissemination. It is possible that immune or metabolic disturbances due to the use of a pneumoperitoneum could contribute to this problem. To investigate this possibility, we studied the effect of two insufflation gases and gasless laparoscopy on in vivo peritoneal macrophage function and intraperitoneal pH in an experimental model. A carcinoma was implanted into the flank of 32 experimental rats that underwent laparoscopic surgery in one of four treatment groups: anesthesia alone, gasless laparoscopy, helium insufflation, and CO2 insufflation. Intraperitoneal pH was monitored during surgery, and peritoneal macrophage function was determined 3 days after surgery by harvesting peritoneal macrophages and then examining their ability to produce tumour necrosis factor-α (TNF-α). CO2 insufflation was associated with a consistent fall in intraperitoneal pH and a significant reduction in TNFα production. These findings did not occur in the other study groups. The results of this study demonstrate that CO2 insufflation results in depressed intraperitoneal macrophage activity. It is possible that it is mediated by pH changes. In addition, it could be a contributing factor to the development of port-site metastases. Further studies are needed to determine whether the factors identified act during clinical surgery.

Copyright information

© by Société Internationale de Chirurgie 2000

Authors and Affiliations

  • Susan J. Neuhaus
    • 1
  • David I. Watson
    • 1
  • Tanya Ellis
    • 1
  • Allan M. Rofe
    • 2
  • George Mathew
    • 1
  • Glyn G. Jamieson
    • 1
  1. 1.The Royal Adelaide Centre for Endoscopic Surgery, University of Adelaide Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia 5000, AustraliaAU
  2. 2.Institute of Medical and Veterinary Science, Adelaide, South Australia 5000, AustraliaAU

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