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Portal venous flow during CO(2) pneumoperitoneum in the rat
1Department of General and Vascular Surgery, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany.
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.