Related Experiment Videos
The impact of gas laparoscopy on abdominal plasminogen activator activity
M Nagelschmidt1, D Gerbecks, T Minor
1Second Department of Surgery, Biochemical and Experimental Division, University of Cologne, Ostmerheimer Strasse 200, 51109 Cologne, Germany.
Background:
The impairment of intestinal perfusion following induction of a pneumoperitoneum may lead to a reduction of peritoneal tissue plasminogen activator (tPA) activity and a concomitant increased risk of adhesion formation.
Methods:
Pigs were laparotomized to take peritoneal biopsy specimens from the cecum, the ileum, and the abdominal wall. A 15 mmHg pneumoperitoneum was established for 3 h by the insufflation of carbon dioxide (group 2, n = 6) or helium (group 3, n = 6). Group 1 (n = 7) received no gas insufflation. After a 2-h recovery period, additional tissue samples were harvested. Specific tPA activity was then determined in the tissue extracts.
Results:
During surgery, specific tPA activity decreased in all the samples. As compared with the control group (100%), this reduction was strongly aggravated in the cecum (-67.6%, p < 0.05) and the ileum (-70.8%) of the CO2 group but only slightly aggravated in the helium group. The parietal peritoneum was not specifically affected by gas insufflation.
Conclusion:
The use of a pneumoperitoneum with carbon dioxide significantly affects peritoneal tPA activity and thus may represent a stimulus for adhesion formation.