C N Gutt1, T C Schmandra. 1. Department of General and Vascular Surgery, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany.
Abstract
BACKGROUND: CO(2) gas insufflation is routinely used to extend the abdominal wall. The resulting pneumoperitoneum has a number of local and systemic effects on the organism. Portal blood flow, which plays an important role in hepatic function and cell-conveyed immune response, is one of the affected parameters. METHODS: An established animal model (rat) of laparoscopic surgery was modified by implanting a perivascular flow probe. Hemodynamics in the portal vein were then measured during increasing intraabdominal pressure generated by carbon dioxide insufflation. RESULTS: Using this technique, an adequate flowmetry of the portal vein was achieved in all animals. The creation of a CO(2) pneumoperitoneum with increasing intraabdominal pressure led to a linear decrease in portal venous flow. CONCLUSIONS: Elevated intraabdominal pressure caused by carbon dioxide insufflation may compromise hepatic function and cell-conveyed immune response during laparoscopic surgery.
BACKGROUND:CO(2)gas insufflation is routinely used to extend the abdominal wall. The resulting pneumoperitoneum has a number of local and systemic effects on the organism. Portal blood flow, which plays an important role in hepatic function and cell-conveyed immune response, is one of the affected parameters. METHODS: An established animal model (rat) of laparoscopic surgery was modified by implanting a perivascular flow probe. Hemodynamics in the portal vein were then measured during increasing intraabdominal pressure generated by carbon dioxide insufflation. RESULTS: Using this technique, an adequate flowmetry of the portal vein was achieved in all animals. The creation of a CO(2) pneumoperitoneum with increasing intraabdominal pressure led to a linear decrease in portal venous flow. CONCLUSIONS: Elevated intraabdominal pressure caused by carbon dioxide insufflation may compromise hepatic function and cell-conveyed immune response during laparoscopic surgery.