Gasless laparoscopy may reduce the risk of port-site metastases following laparascopic tumor surgery.
OBJECTIVE
To compare the incidence of port-site metastases in an experimental tumor model following tumor manipulation during laparoscopy aided by conventional insufflation with laparoscopy using a gasless technique.


METHODS
An experimental model applied in a research laboratory.


METHODS
Malignant tumors were implanted in the abdominal wall of 24 rats. Twelve rats underwent tumor laceration at laparoscopy with carbon dioxide insufflation, and 12 rats underwent the same procedure during gasless laparoscopy achieved by abdominal wall suspension. Rats were killed 1 week later and were examined for evidence of tumor metastases. The surgical wounds were examined microscopically by a histopathologist who was unaware of the operative technique used and the site of origin of the specimens.


METHODS
Histologically confirmed tumor metastasis to laparoscopic port wounds.


RESULTS
Growth of the primary tumor was equal in both groups. Wound metastases were less likely in the gasless laparoscopy group (3 of 12 vs 10 of 12; P = .01, Fisher exact test).


CONCLUSIONS
The use of laparoscopy without gas insufflation may reduce the risk of wound metastasis following laparoscopic surgery for cancer.
Watson
D I
DI
Royal Adelaide Centre for Endoscopic Surgery, Royal Adelaide Hospital, South Australia.
Mathew
G
G
Ellis
T
T
Baigrie
C F
CF
Rofe
A M
AM
Jamieson
G G
GG
D000818:Animals; D002245:Carbon Dioxide; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods*; D009366:Neoplasm Seeding; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D051381:Rats; D012307:Risk Factors
D002245:Carbon Dioxide