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Anatomical changes due to pneumoperitoneum analyzed by MRI: an experimental study in pigs

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Abstract

Purpose

Different effects on cardiovascular and respiratory systems and liver are associated with pneumoperitoneum. This study aimed to determine the morphological changes in the abdominal anatomy as a result of increased intra-abdominal pressure due to pneumoperitoneum using MRI.

Methods

Ten healthy female pigs were used in this study. MRI studies of the abdomen in supine position were made before the creation of pneumoperitoneum and 1 h after increasing the pressure to 14 mmHg. Changes in area, volume, and longitudinal and transverse length of the liver were measured. The diameters of the lumen of the abdominal aorta, the inferior vena cava and portal vein were observed in three positions along the abdominal cavity. The position of the diaphragm after the induction of pneumoperitoneum was also analyzed.

Results

After induction of pneumoperitoneum, volume and transverse length of the liver was significantly increased, while peak area was decreased. Stenosis in the aortic lumen was observed (P < 0.05). Longitudinal and transverse diameters of the portal lumen were reduced, but significant differences were only found in the longitudinal diameter. Alterations in the diameter of the inferior vena cava lumen were obtained in three analyzed positions, but differences were significant only in two of them. A mean cranial displacement of the diaphragm equal to 25 mm was also observed.

Conclusion

Increasing abdominal pressure up to laparoscopic pressure (14 mmHg) provokes morphological changes in the liver, vascular structures and diaphragm. These changes could be related to functional alterations that different organs experience after the induction of pneumoperitoneum.

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Acknowledgments

This work was funded by INNAVLAP (CIT-300100-2007-55) from the Ministerio de Ciencia e Innovación, Spain.

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Authors and Affiliations

  1. Laparoscopy Unit, Minimally Invasive Surgery Centre Jesús Usón, Caceres, Spain

    F. M. Sánchez-Margallo, L. Correa & J. Usón-Gargallo

  2. Bioengineering and Health Technology Unit, Minimally Invasive Surgery Centre Jesús Usón, Caceres, Spain

    J. L. Moyano-Cuevas, J. B. Pagador, L. F. Sánchez-Peralta & J. A. Sánchez-Margallo

  3. Department of Anatomy of the Faculty of Veterinary, University of Murcia, Murcia, Spain

    R. Latorre

  4. General Surgery Unit, Minimally Invasive Surgery Centre Jesús Usón, Caceres, Spain

    J. Maestre

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  1. F. M. Sánchez-Margallo
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  2. J. L. Moyano-Cuevas
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  3. R. Latorre
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  4. J. Maestre
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  5. L. Correa
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  6. J. B. Pagador
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  8. J. A. Sánchez-Margallo
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  9. J. Usón-Gargallo
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Correspondence to J. L. Moyano-Cuevas.

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Sánchez-Margallo, F.M., Moyano-Cuevas, J.L., Latorre, R. et al. Anatomical changes due to pneumoperitoneum analyzed by MRI: an experimental study in pigs. Surg Radiol Anat 33, 389–396 (2011). https://doi.org/10.1007/s00276-010-0763-9

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  • DOI: https://doi.org/10.1007/s00276-010-0763-9

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