Effect of adding more than 3% oxygen to carbon dioxide pneumoperitoneum on adhesion formation in a laparoscopic mouse model.
OBJECTIVE
To investigate the effect of the addition of 3% or higher oxygen concentrations to the carbon dioxide (CO2) pneumoperitoneum.


METHODS
Prospective, randomized trial.


METHODS
Academic research center.


METHODS
Female Naval Medical Research Institute mice (n = 100).


METHODS
Sixty minutes of CO2 pneumoperitoneum with 0%, 3%, 6%, 9%, or 12% oxygen; induction of adhesions by the creation of standardized peritoneal lesions during laparoscopy.


METHODS
Adhesions were quantitatively and qualitatively scored after 7 days during laparotomy to determine [1] the effect of 60 minutes of CO2 pneumoperitoneum with 0%, 3%, 6%, 9%, or 12% oxygen on adhesion formation, and [2] the effect of duration of CO2 pneumoperitoneum and insufflation pressure on adhesion formation with the addition of 0%, 3%, and 12% oxygen.


RESULTS
Compared with a CO2 pneumoperitoneum with 3% oxygen, adhesion formation is greater when either no oxygen or more than 3% oxygen is added to the CO2 pneumoperitoneum. These effects persisted at higher insufflation pressures and longer duration of pneumoperitoneum, both known to increase adhesion formation with pure CO2.


CONCLUSIONS
This study confirms that adhesion formation is decreased with the addition of 3% oxygen to the CO2 pneumoperitoneum. The addition of higher oxygen concentrations, however, is deleterious. Adhesions always increase with time and duration of the pneumoperitoneum.
Elkelani
Osama Ali
OA
Department of Obstetrics and Gynecology, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium.
Binda
Maria Mercedes
MM
Molinas
Carlos Roger
CR
Koninckx
Philippe Robert
PR
D000818:Animals; D002245:Carbon Dioxide; D004305:Dose-Response Relationship, Drug; D005260:Female; D010535:Laparoscopy; D051379:Mice; D008815:Mice, Inbred Strains; D010100:Oxygen / Q000008:administration & dosage* / Q000494:pharmacology; D010532:Peritoneal Diseases / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D011028:Pneumoperitoneum, Artificial; D011897:Random Allocation; D013997:Time Factors; D000267:Tissue Adhesions / Q000209:etiology / Q000473:pathology / Q000517:prevention & control
D002245:Carbon Dioxide; D010100:Oxygen