The effect of lavage on intraabdominal cell burden.
BACKGROUND
Abdominal lavage is a common surgical practice, but few studies have been conducted to assess its efficacy at removing cells from the abdominal cavity, particularly during laparoscopic surgery.


METHODS
After three 12-mm trocars were inserted into six female 30-kg pigs at the umbilicus left and right iliac fossae, the abdomen was insufflated with carbon dioxide. The pelvis of each pigs was injected with 6 million radiolabeled LIM 1215 cells. Then the abdominal cavity was irrigated with either 500 ml 0.9% saline, 500 ml 10% betadine solution, or 1 L 0.9% saline. A maximum of 5 L of solution was used for each animal. The lavage fluid was suctioned into separate containers after each aliquot, and each container was measured for radioactivity.


RESULTS
Significantly greater numbers of cells were removed by lavage by the first to third lavage cycle; however, after four lavage cycles, relatively few cells were removed by each further cycle. No difference was observed between 500-ml and 1-L aliquots. Additionally, the mechanical efficacy of 0.9% saline and 10% betadine solution appeared similar.


CONCLUSIONS
These findings suggest that optimal lavage consists of four irrigation/suction cycles utilizing 500-ml aliquots.
Brundell
S M
SM
Department of Surgery, The University of Adelaide, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.
Tucker
K
K
Chatterton
B
B
Hewett
P J
PJ
D000005:Abdomen / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D000818:Animals; D001202:Ascitic Fluid / Q000000981:diagnostic imaging / Q000473:pathology; D002245:Carbon Dioxide / Q000627:therapeutic use; D002452:Cell Count; D002470:Cell Survival / Q000528:radiation effects; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D007274:Injections, Intraperitoneal; D007327:Insufflation / Q000379:methods; D009368:Neoplasm Transplantation / Q000000981:diagnostic imaging / Q000379:methods; D010388:Pelvis / Q000473:pathology; D010533:Peritoneal Lavage / Q000009:adverse effects*; D010537:Peritoneum / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000032:analysis; D013552:Swine; D019690:Technetium Tc 99m Exametazime / Q000032:analysis; D014407:Tumor Cells, Cultured; D014472:Umbilicus / Q000601:surgery
D019275:Radiopharmaceuticals; D002245:Carbon Dioxide; D019690:Technetium Tc 99m Exametazime