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The role of the spleen in laparoscopy-associated inflammatory response

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Abstract

Background:

Carbon dioxide (CO2) pneumoperitoneum alters the inflammatory response in animal models of sepsis. The spleen is a key organ in inflammation and its removal was predicted to modify this effect.

Methods:

The acute phase inflammatory response to lipopolysaccharide (LPS) challenge in male rats was examined for the effects of splenectomy (spx) and the technique of removal (open or laparpscopic). A series of experiments compared LPS-only controls with LPS injection 2 or 9 days following open spx, lap CO2 spx, open sham, or lap CO2 sham. The method of splenectomy was studied by randomization to control, open spx, lap CO2 spx, lap helium (He) spx, or lap air spx with LPS challenge on postoperative day 2. Serum levels of tumor necrosis factor-α (TNF-α), interferon-γ (INF-γ) and, interleutin (IL) 10 were collected at multiple time points, assayed by commercial enzyme-linked immunosorbent assay, analyzed by analysis of variance.

Results:

Levels of TNF-α at 1.5 were significantly lower following open sham than following lap sham (p < 0.05). Splenectomy drastically reduced INF-γ and TNF-α levels compared to controls (p < 0.05) on postoperative day 2. No method of spx preserved TNF-α or INF-γ responses. Recovery of TNF-α response on day 9 was delayed in the spx groups.

Conclusions:

Splenectomy dramatically reduces TNF-α and INF-γ responses to LPS challenge, although by different mechanisms. Pneumoperitoneum-mediated modulation of the septic inflammatory response is partially dependent on the spleen.

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Acknowledgment

This project was funded by a SAGES endoscopic/laparoscopic research award.

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Authors and Affiliations

  1. Department of Surgery, Center for Minimally Invasive Surgery, Johns Hopkins University School of Medicine, Baltimore 21287-4665, MD, USA

    S. L. Bachman, E. J. Hanly, D. Saad, J. I. Nwanko, J. Lamb, A. E. Herring & M. A. Talamini

  2. Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    E. J. Hanly

  3. Malcolm Grow Medical Center, 1050 Perimeter Road, Andrews AFB, MD 20762, USA

    M. R. Marohn & A. De-Maio

Authors
  1. S. L. Bachman
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  2. E. J. Hanly
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  3. D. Saad
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  4. J. I. Nwanko
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  5. J. Lamb
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  6. A. E. Herring
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  7. M. R. Marohn
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  8. A. De-Maio
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  9. M. A. Talamini
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Corresponding author

Correspondence to M. A. Talamini.

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Bachman, S.L., Hanly, E.J., Saad, D. et al. The role of the spleen in laparoscopy-associated inflammatory response. Surg Endosc 19, 1035–1044 (2005). https://doi.org/10.1007/s00464-004-8820-2

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  • DOI: https://doi.org/10.1007/s00464-004-8820-2

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