Peritoneal mesothelial hypoxia during pneumoperitoneum is a cofactor in adhesion formation in a laparoscopic mouse model.
OBJECTIVE
To develop a laparoscopic mouse model to evaluate the hypothesis that mesothelial hypoxia during pneumoperitoneum is a cofactor in adhesion formation.


METHODS
Prospective randomized trials.


METHODS
Academic research center.


METHODS
One hundred thirty female Naval Medical Research Institute (NMRI) mice.


METHODS
Adhesions were induced by opposing monopolar lesions in uterine horns and pelvic side walls during laparoscopy and evaluated after 7 or 28 days under microscopic vision during laparotomy. The following pneumoperitoneum variables were assessed: duration (10 or 60 minutes), insufflation pressure (5 or 15 cm of water), insufflation gas (CO(2) or helium), and addition of oxygen (0-12%).


METHODS
Adhesions were scored quantitatively and qualitatively for extent, type, and tenacity.


RESULTS
Scoring of adhesions 7 or 28 days after laparoscopic surgery was comparable. Adhesions increased with duration of pneumoperitoneum and with insufflation pressure and decreased with the addition of oxygen. Half-maximal reduction of adhesions was obtained at 1.5% oxygen, whereas a maximal reduction required only 2%-3%. The effect of CO(2) and helium was similar.


CONCLUSIONS
These data demonstrate the feasibility of the intubated laparoscopic mouse model and confirm previous observations in rabbits, indicating that mesothelial hypoxia plays a key role in adhesion formation.
Molinas
C R
CR
Center for Surgical Technologies, Katholieke Universiteit Leuven, Belgium. rogermolinas@hotmail.com
Mynbaev
O
O
Pauwels
A
A
Novak
P
P
Koninckx
P R
PR
D000818:Animals; D004195:Disease Models, Animal; D004848:Epithelium / Q000502:physiology / Q000503:physiopathology; D005260:Female; D000860:Hypoxia / Q000503:physiopathology*; D010535:Laparoscopy; D051379:Mice; D008815:Mice, Inbred Strains; D023421:Models, Animal; D010532:Peritoneal Diseases / Q000473:pathology / Q000503:physiopathology*; D010537:Peritoneum / Q000502:physiology / Q000503:physiopathology*; D011027:Pneumoperitoneum / Q000473:pathology / Q000503:physiopathology*; D000267:Tissue Adhesions / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D014591:Uterine Diseases / Q000473:pathology / Q000503:physiopathology*