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The Effects of Different Pressure Pneumoperitoneum Models Created By Standard or Heated-Humidified CO2 Insufflation on Ovary and Peritoneum: an Experimental Study in Rats

  • General Gynecology: Original Article
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Abstract

There is still controversy over whether structural and morphological changes can be observed in tissues depending on the carbon dioxide (CO2) nature or the applied intra-abdominal pressures (IAP). This study aimed to investigate the effects of different pressure or CO2 nature used for pneumoperitoneum in gynecological laparoscopic surgery on inflammation, DNA damage, oxidative stress, and histopathological changes in ovarian and peritoneal tissue. For this purpose, forty female rats were randomly divided into 6 groups and different pneumoperitoneum models were created in these groups. Rats in group other than control and sham groups received standard (CD) or heated-humidified CO2 (HH) insufflations at low (4 mmHg) or high pressure (8 mmHg). The ovary and peritoneum sections were evaluated microscopically for apoptotic index (API) and API scoring was calculated. Tissue and plasma interleukin-6 (IL-6), tumor necrotizing factor-alpha (TNF-α), anti-Mullerian hormone (AMH) and 8-hydroxydeoxyguanosine (8-OHdG) levels were analyzed with enzyme-linked immunosorbent assay (ELISA). The most severe changes occurred in the 8CD group microscopically, while the least severe changes occurred in the 4HH group. All histopathological parameters except for ovarian apoptotic index and peritoneal PCNA at low pressure were higher in the CD group. TNF-α and 8-OHdG levels were higher in the CD group at both low and high pressures. Standard CO2 caused more prominent histopathological changes at high pressures and systemic inflammation in both pressure groups. The least change between the experimental study groups in terms of histopathological and biochemical was observed in the low-pressure heated-humidified group.

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Abbreviations

PCNA:

Proliferating cell nuclear antigen

INOS:

Inducible nitric oxide synthase

IL-6:

Interleukin 6

TNF-α:

Tumor necrosis factor α

AMH:

Anti-Mullerian hormone

8-OHdG:

8-Hydroxy-2′-deoxyguanosine

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Funding

This study was supported by the Ege University Scientific Research Projects Coordination Unit (grant number: TGA-2019–20808 (to Ilkben Gunusen)).

Author information

Authors and Affiliations

  1. Department of Anesthesiology and Reanimation, Faculty of Medicine, Ege University, Izmir, Turkey

    Ilkben Gunusen, Asuman Sargin & Semra Karaman

  2. Department of Obstetrics and Gynecology, Faculty of Medicine, Ege University, Izmir, Turkey

    Ali Akdemir

  3. Department of Histology and Embryology, Faculty of Medicine, Ege University, 35100, Bornova, Izmir, Turkey

    Cevik Gurel & Gokce Ceren Kuscu

  4. Department of Physiology, Faculty of Medicine, Ege University, Izmir, Turkey

    Dilek Taskiran

  5. Department of Neuroscience, Institute of Health Sciences, Ege University, Izmir, Turkey

    Kubra Celik

Authors
  1. Ilkben Gunusen
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  2. Ali Akdemir
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  3. Cevik Gurel
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  4. Asuman Sargin
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  6. Gokce Ceren Kuscu
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  8. Semra Karaman
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Corresponding author

Correspondence to Cevik Gurel.

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Ethics Approval

Experimental procedures used in this study were approved by Ege University, Local Ethics Committee for Animal Experiments (approval no: 2019–045). All experimental procedures carried out in the same center with strict accordance with the recommendations in the ARRIVE guidelines (Animals in Research: Reporting In Vivo Experiments).

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The authors declare no competing interests.

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Gunusen, I., Akdemir, A., Gurel, C. et al. The Effects of Different Pressure Pneumoperitoneum Models Created By Standard or Heated-Humidified CO2 Insufflation on Ovary and Peritoneum: an Experimental Study in Rats. Reprod. Sci. 29, 1197–1208 (2022). https://doi.org/10.1007/s43032-022-00878-2

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  • DOI: https://doi.org/10.1007/s43032-022-00878-2

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