title: Is intestinal ischemia a risk of laparoscopy? An experimental study in rabbits.
abstract: OBJECTIVE
  In the literature, there are few reports documenting intra-abdominal organ necrosis following laparoscopic procedures. This experimental study was planned to investigate whether intestinal ischemia develops during laparoscopic procedures and if laparoscopy could cause intestinal necrosis.
  
  
  METHODS
  Two experimental groups, each consisting of 10 adult New-Zealand rabbits, were used in this study. The first group comprised the study group which had pneumoperitoneum, the second group comprised the normal animals serving as the controls. A cervical tracheostomy was performed to achieve successful general anesthesia in both groups. In the study group, intraperitoneal CO2 insufflation was carried out and intraabdominal pressure (IAP) was adjusted so as not to exceed the arterial blood pressure. After 20 min high IAP period, the intraabdominal gas was aspirated. Five minutes later, samples of both small intestine and colon tissue were taken. In the control group, tissue samples were taken 25 min after anesthesia was achieved. Xanthine oxidase (XO) and malondialdehyde (MDA) levels were measured as indicators of intestinal ischemia and lipid peroxidation in the intestinal tissues. Statistical analysis was done to compare the XO and MDA levels of the small intestines and colons of both groups.
  
  
  RESULTS
  The mean colonic XO levels were 1.323+/-1.17 and 0.217+/-0.27 (U/mg protein) in study and control groups, respectively. This difference was statistically significant (t = 2.60, p<0.05). The other comparisons with regard to XO and MDA levels were statistically not significant.
  
  
  CONCLUSIONS
  Our results demonstrate that intraperitoneal CO2 insufflation in which intraabdominal pressure was adjusted to be lower than arterial blood pressure may affect oxygenization of the colon.
authors.affiliation: Department of Pediatric Surgery and Biochemistry, Cerrahpasa Medical Faculty, University of Istanbul, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Emir
authors.forename: M
authors.initials: M
authors.lastname: Akman
authors.forename: A
authors.initials: A
authors.lastname: Belce
authors.forename: K
authors.initials: K
authors.lastname: Gümüştaş
authors.forename: Y
authors.initials: Y
authors.lastname: Söylet
mesh_terms: D000818:Animals; D001707:Biopsy, Needle; D001784:Blood Gas Analysis; D017091:Colitis, Ischemic / Q000209:etiology* / Q000473:pathology*; D004195:Disease Models, Animal; D005260:Female; D006863:Hydrogen-Ion Concentration; D007420:Intestine, Large / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology*; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D011028:Pneumoperitoneum, Artificial; D011336:Probability; D011817:Rabbits; D012016:Reference Values; D018570:Risk Assessment