title: Saline-filled laparoscopic surgery: A basic study on partial hepatectomy in a rabbit model.
abstract: BACKGROUND
  There is still a poor understanding of the effects of pneumoperitoneum with insufflation of carbon dioxide gas (CO2) on malignant cells, and pneumoperitoneum has a negative impact on cardiopulmonary responses. A novel saline-filled laparoscopic surgery (SAFLS) is proposed, and the technical feasibility of performing saline-filled laparoscopic partial hepatectomy (LPH) was evaluated in a rabbit model.
  
  
  METHODS
  Twelve LPH were performed in rabbits, with six procedures performed using an ultrasonic device with CO2 pneumoperitoneum (CO2 group) and six procedures performed using a bipolar resectoscope (RS) in a saline-filled environment (saline group). Resection time, CO2 and saline consumption, vital signs, blood gas analysis, complications, interleukin-1 beta (IL-1β) and C-reactive protein (CRP) levels were measured. The effectiveness of the resections was evaluated by the pathological findings.
  
  
  RESULTS
  LPH was successfully performed with clear observation by irrigation and good control of bleeding by coagulation with RS. There were no significant differences in all perioperative values, IL-1βand CRP levels between the two groups. All pathological specimens of the saline group showed that the resected lesions were coagulated and regenerated as well as in the CO2 group.
  
  
  CONCLUSIONS
  SAFLS is feasible and provides a good surgical view with irrigation and identification of bleeding sites.
authors.affiliation: Department of General and Cardiothoracic Surgery, Kanazawa University School of Medicine , Kanazawa , Japan.
authors.forename: Masanari
authors.initials: M
authors.lastname: Shimada
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kawaguchi
authors.forename: Norihiko
authors.initials: N
authors.lastname: Ishikawa
authors.forename: Go
authors.initials: G
authors.lastname: Watanabe
mesh_terms: D000818:Animals; D002245:Carbon Dioxide; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D011028:Pneumoperitoneum, Artificial / Q000379:methods; D011817:Rabbits; D012965:Sodium Chloride
chemical_list: D002245:Carbon Dioxide; D012965:Sodium Chloride
keywords: Laparoscopic surgery; hepatectomy; rabbit model; resectoscope; saline