Abstract
During laparoscopic surgery, gases such as carbon dioxide (CO2), helium, or normal air are insufflated into the intra-abdominal cavity so the surgeon can obtain a clear surgical field; however, this insufflation technique may cause injury to the intra-abdominal organs. This study was undertaken to evaluate the effects of different pressures of CO2 on the apoptotic index in the peritoneum during laparoscopic surgery. A total of 30 Sprague-Dawley male rats were used in the study. CO2 was insufflated into the intra-abdominal cavity via an angiocatheter cannula by an insufflator at pressures of 10 and 20 mm Hg over 60 min. In the control group, the cannula was inserted into the intra-abdominal cavity, but no gas was insufflated. After 60 min, the rats were killed; peritoneum was harvested from the abdominal wall and was cultured in the cell culture laboratory. Apoptotic and living cells were detected immunohistochemically, and the apoptotic index was calculated and statistically analyzed. The data collected revealed that the apoptotic index increases in proportion to the level of CO2 pressure. CO2 pneumoperitoneum is a very useful technique. Gas pressure must be carefully set during the operation, however, or injured mesothelial cells may cause serious malfunction.
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References
Davis CJ, Filipi CJ. A history of endoscopic surgery. In: Arregui ME, Fitzgibbons RJ, Kotkhoude M, McKernan JB, Reich H, eds.Principles of Laparoscopic Surgery: Basic and Advanced Techniques. New York: Springer; 1995:3.
Rosario MTA, Ribeiro U Jr, Corbet CEP, et al. Does CO2 pneumoperitoneum alter the ultra-structure of the mesothelium?J Surg Res. 2006;133:84–88.
Lindström P, Kallskog Ö, Wadström J, et al. Blood flow distribution during elevated intraperitoneal pressure in the rat.Acta Physiol Scand. 2003;177:149–156.
Erikoglu M, Yol S, Avunduk MC, et al. Electron-microscopic alterations of the peritoneum after both cold and heated carbon dioxide pneumoperitoneum.J Surg Res. 2005;125:73–77.
Sare M, Yilmaz I, Hamamci D, et al. The effect of carbon dioxide pneumoperitoneum on free radicals.Surg Endosc. 2000;14:649–652.
Gutt CN, Kim ZG, Schmandra T, et al. Carbon dioxide pneumoperitoneum is associated with increased liver metastases in a rat model.Surgery. 2000;127:566–570.
Ikramuddin S, Lucas J, Ellison EC, et al. Detection of aerosolized cells during carbon dioxide laparoscopy.J Gastrointest Surg. 1998;2:580–584.
Lundberg O, Kristofferson A. Effect of pneumoperitoneum induced by carbon dioxide and air on tumor load in a rat model.World J Surg. 1998;22:470–472.
Yamaguchi K, Hirabayashi T, Suematsu T, et al. Hyaluronic acid secretion during carbon dioxide pneumoperitoneum and its association with port-site metastasis in a murine model.Surg Endosc. 2001;15:59–62.
Kopernik G, Avinoach E, Grossman Y, et al. The effect of high partial pressure of carbon dioxide environment on metabolism and immune function of human peritoneal cells: relevance to carbon dioxide pneumoperitoneum.Am J Obstet Gynecol. 1998;179:1503–1509.
Unsal MA, Imamoglu M, Cay A, et al. Acute alterations in biochemistry, morphology and contractility of rat isolated urinary bladder via increased intra-abdominal pressure.Gynecol Obstet Invest. 2006;61:179–187.
Schachtrupp A, Toens CH, Hoer J, et al. 24 h pneumoperitoneum leads to multiple organ impairment in a porcine model.J Surg Res. 2002;106:37–45.
Tosun M, Kalkan S. Importance of apoptosis in intrauterine period.Sendrom. 2002;14:95–104.
Tosun M, Kalkan S. Apoptosis and its importance.Sendrom. 2002;14:120–126.
Polat C, Yilmaz S, Gokce O. Does ischemia occur during laparoscopic cholecystectomy?Surg Endosc. 2003;17:1337–1338. Epub June 13, 2003.
Andersson L, Wallin CJ, Sollevi A, et al. Pneumoperitoneum in healthy humans does not affect central blood volume or cardiac output.Acta Anaesthesiol Scand. 1999;43:809–814.
Gründel K, Böhm B, Bauwenss K, et al. Influence of acute hemorrhage and pneumoperitoneum on hemodynamic and respiratory parameters.Surg Endosc. 1998;12:809–812.
Glew PA, Campher MJJ, Pearson K, et al. The effect of warm humidified CO2 on the dissipation of residual gas following laparoscopy in piglets.J Am Assoc Gynecol Laparosc. 2004;11:204–210.
Hopkins MP, vonGruenigen V, Haller NA, et al. The effect of various sufflation gases on tumor implantation in an animal model.Am J Obstet Gynecol. 2002;187:994–996.
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Tosun, M., Samli, H., Arikan, Y. et al. The effects of CO2 pneumoperitoneum on the apoptotic index in the peritoneum. Adv Therapy 24, 883–889 (2007). https://doi.org/10.1007/BF02849981
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DOI: https://doi.org/10.1007/BF02849981