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Related Experiment Videos

Increased transperitoneal bacterial translocation in laparoscopic surgery.

M C Horattas1, N Haller, D Ricchiuti

  • 1Akron General Medical Center, Northeastern Ohio Universities College of Medicine, 400 Wabash Avenue, Akron, Ohio 44307, USA.

Surgical Endoscopy
|June 13, 2003
PubMed
Summary

Pneumoperitoneum with carbon dioxide (CO2) or helium during peritonitis in rats increases bacterial translocation, especially at lower pressures. The type of gas used was less significant than the presence of gas and pressure levels.

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Area of Science:

  • Surgical innovation and patient safety
  • Microbiology and infection control
  • Gastrointestinal disease research

Background:

  • Laparoscopic surgery indications are expanding to include peritonitis-associated conditions.
  • The safety of carbon dioxide (CO2) pneumoperitoneum in peritonitis remains unproven.
  • Previous studies indicated increased bacteremia with CO2 insufflation.

Purpose of the Study:

  • To investigate bacterial translocation with different gases and pressures during pneumoperitoneum.
  • To clarify the roles of intra-abdominal pressure and gas type in bacterial translocation.
  • To assess the safety of CO2 and helium pneumoperitoneum in a peritonitis model.

Main Methods:

  • 110 rats with induced peritonitis were inoculated with Escherichia coli.

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  • Groups included a control (no pneumoperitoneum), and pneumoperitoneum with helium or CO2 at 14 mmHg and 3 mmHg.
  • Blood cultures were monitored for bacterial translocation over 165 minutes.

    • Main Results:

    • Pneumoperitoneum significantly increased bacterial translocation compared to controls.
    • Bacterial translocation was elevated in low-pressure (3 mmHg) groups for both helium and CO2.
    • Gas type was less influential than the presence of gas and pressure in bacterial translocation.

    Conclusions:

    • Insufflation with CO2 or helium increases bacterial translocation in a rat peritonitis model.
    • Lower insufflation pressures (3 mmHg) are associated with a greater risk of bacterial translocation.
    • Clinical conclusions on gas type or pressure effects remain unconfirmed.