title: [Peritoneum and laparoscopic environment].
abstract: Laparoscopic surgery takes place in a closed environment, the peritoneal cavity distended by the pneumoperitoneum whose parameters, such as pressure, composition, humidity and temperature of the gas, may be changed and adapted to influence the intra and postoperative surgical processes. Such changes were impossible in the "open" environment. This review includes recent data on peritoneal physiology, which are relevant for surgeons, and on the effects of the pneumoperitoneum on the peritoneal membrane. The ability to work in a new surgical environment, which may be adapted to each situation, opens a new era in endoscopic surgery. Using nebulizers, the pneumoperitoneum may become a new way to administer intraoperative treatments. Most of the current data on the consequences of the pneumoperitoneum were obtained using poor animal models so that it remains difficult to estimate the progresses, which will be brought to the operative theater by this new concept. However this revolution will likely be used by thoracic or cardiac surgeon who are also working in a serosa. This approach may even appear essential to all the surgeons who are using endoscopy in a retroperitoneal space such as urologists or endocrine surgeons.
authors.affiliation: Service de gynécologie obstétrique et médecine de la reproduction, CHU, Polyclinique Hôtel-Dieu bd Léon-Malfreyt, 63058 Clermont-Ferrand Cedex 1, France. mcanis@chu-clermontferrand.fr
authors.forename: Michel
authors.initials: M
authors.lastname: Canis
authors.forename: Sachiko
authors.initials: S
authors.lastname: Matsuzaki
authors.forename: Nicolas
authors.initials: N
authors.lastname: Bourdel
authors.forename: Kris
authors.initials: K
authors.lastname: Jardon
authors.forename: Benjamin
authors.initials: B
authors.lastname: Cotte
authors.forename: Revaz
authors.initials: R
authors.lastname: Botchorishvili
authors.forename: Benoit
authors.initials: B
authors.lastname: Rabischong
authors.forename: Gérard
authors.initials: G
authors.lastname: Mage
mesh_terms: D000818:Animals; D015687:Cell Hypoxia; D003713:Dendritic Cells / Q000502:physiology; D004847:Epithelial Cells / Q000502:physiology; D006801:Humans; D007111:Immunity, Cellular; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008264:Macrophages / Q000502:physiology; D009330:Nebulizers and Vaporizers; D009852:Omentum / Q000502:physiology; D010537:Peritoneum / Q000166:cytology / Q000473:pathology / Q000502:physiology; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects / Q000379:methods; D011312:Pressure / Q000009:adverse effects; D000267:Tissue Adhesions / Q000209:etiology
vernacular_title: Péritoine et environnement coelioscopique.