title: Prolonged capnoperitoneum does not cause postoperative ileus in pigs: safety of prolonged capnoperitoneum.
abstract: BACKGROUND
  Operative time is an accepted risk factor for the development of postoperative ileus (POI). Innovative surgical procedures such as robotic surgery and natural orifice transluminal endoscopic surgery (NOTES) will be associated with longer operative times. Although intraabdominal manipulation is a major factor for POI the impact of prolonged capnoperitoneum on postoperative gastrointestinal transit time (GIT-TT) has rarely been studied.
  
  
  METHODS
  IRB approved survival pilot study to assess postoperative GIT-TT using fecal collection and chromium-oxide (Cr2O3) labeling in pigs. Twelve female pigs were randomly assigned to three groups of four animals each. Group A received eight hours anesthesia and pressure-controlled high flow capnoperitoneum (15 mmHg), group B eight hours of anesthesia only and group C no intervention. No intraoperative manipulation. The pilot study was terminated after eight days.
  
  
  RESULTS
  None of the animals developed POI. In Group A one animal died after eight hours of general anesthesia. No differences in postoperative fecal output, Cr2O3 excretion rate or weight gain were found.
  
  
  CONCLUSIONS
  This study is the first to investigate eight hours of capnoperitoneum in a survival model. GIT-TT is not affected by prolonged capnoperitoneum in pigs. No POI occurred with prolonged capnoperitoneum. Prolonged capnoperitoneum is safe regarding postoperative gastrointestinal function in innovative surgical procedures.
authors.affiliation: Saarland University Hospitals, Department of Surgery , Homburg/Saar , Germany.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Borchert
authors.forename: Peter
authors.initials: P
authors.lastname: Köhler
authors.forename: Tarkan
authors.initials: T
authors.lastname: Jäger
authors.forename: Mike
authors.initials: M
authors.lastname: Diederich
authors.forename: Liane
authors.initials: L
authors.lastname: Hüther
authors.forename: Andreas
authors.initials: A
authors.lastname: Berk
authors.forename: Wolfram
authors.initials: W
authors.lastname: Lamade
mesh_terms: D000768:Anesthesia, General / Q000379:methods; D000818:Animals; D002245:Carbon Dioxide / Q000008:administration & dosage; D005260:Female; D005772:Gastrointestinal Transit / Q000502:physiology; D045823:Ileus / Q000209:etiology*; D061646:Operative Time; D010865:Pilot Projects; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology*; D012307:Risk Factors; D013552:Swine; D013997:Time Factors
chemical_list: D002245:Carbon Dioxide
keywords: Capnoperitoneum; NOTES; minimally invasive surgery; postoperative ileus; safety