Effect of desiccation and temperature during laparoscopy on adhesion formation in mice.
OBJECTIVE
To investigate the effects of desiccation (without cooling) and of oversaturation of the pneumoperitoneum on adhesion formation.


METHODS
Prospective randomized trial.


METHODS
Academic research center.


METHODS
BALB/c and NMRI female mice.


METHODS
The effect of desiccation using nonhumidified CO(2) on adhesion formation was evaluated in a laparoscopic mouse model. Body temperature (BT) was maintained at 37 degrees C using a homeothermic blanket. In addition to controls without desiccation, the effect of both hypothermia and desiccation on adhesion formation was evaluated. Subsequently the effect of oversaturating the pneumoperitoneum using a high energy gas to avoid any desiccation was studied.


METHODS
During surgery BT, pneumoperitoneum temperature, and relative humidity were monitored. Adhesions were scored after 7 days.


RESULTS
Adhesions increased with increasing levels of desiccation when BT was kept at 37 degrees C. This was prevented with humidified gas. If BT decreased, adhesions were fewer. Oversaturating the pneumoperitoneum increased adhesions due to high energy gas causing an increase in both BT and pneumoperitoneum temperature.


CONCLUSIONS
Adhesions increase with desiccation and decrease when BT is reduced. Adhesions are minimized when humidified gas is used. Since desiccation is associated with cooling, its effect is generally underestimated because of the counterbalance with cooling. The concept of combining controlled intraperitoneal cooling with a rigorous prevention of desiccation might be important for clinical adhesion prevention.
Binda
Maria Mercedes
MM
Department of Obstetrics and Gynecology, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium. MariaMercedes.Binda@uz.kuleuven.ac.be
Molinas
Carlos Roger
CR
Hansen
Paul
P
Koninckx
Philippe Robert
PR
D000818:Animals; D003890:Desiccation / Q000379:methods*; D005260:Female; D006358:Hot Temperature / Q000009:adverse effects; D010535:Laparoscopy / Q000009:adverse effects*; D051379:Mice; D008807:Mice, Inbred BALB C; D010532:Peritoneal Diseases / Q000209:etiology* / Q000473:pathology*; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D013696:Temperature; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000209:etiology* / Q000473:pathology*