A study on the effect of insufflation gases employed in laparoscopy on various organs: A rat model
Semih Lutfi Mirapoglu1, Sümeyye Koç2, Doğan Yıldırım3, Mahmut Said Değerli3, Ganime Çoban4, Nurcan Ünver5, Ömer Faruk Özer4, Kamil Şahin6, Ceyhan Şahin1, Ali Çay71Department of Pediatric Surgery, University of Health Sciences Umraniye Training and Research Hospital, Istanbul, Türkiye2Department of Medical Biochemistry, University of Health Sciences Türkiye, Faculty of Hamidiye Medicine, Istanbul, Türkiye
3Department of General Surgery, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Türkiye
4Department of Medical Biochemistry Bezmialem Vakıf University, Medical Faculty, Istanbul, Türkiye
5Department of Pathology, Yedikule Pulmonary Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Türkiye
6Department of Pediatrics, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Türkiye
7Department of Pediatric Surgery, Buyukcekmece Mimar Sinan State Hospital, Istanbul, Türkiye
INTRODUCTION: In laparoscopic surgery, pneumoperitoneum is created using carbon dioxide, helium, or ambi-ent air. We aimed to investigate the effects of these gases on the organs.
METHODS: The experiment involved 25 male Sprague-Dawley rats aged 5-6 months, were divided into four groups. Group 1 (n=4) was the control group. Pneumoperitoneum was induced in Groups 2 (n=7), 3 (n=7), and 4 (n=7) using carbon dioxide, helium, and room air, respectively. After 2 hours, the gas was evacuated, and blood samples were collected. Blood was drawn 24 h later. The rats were euthanized, and tissue samples from the liver, pancreas, kidney, intestine, and lungs were collected for examination.
RESULTS: There were no significant differences in the severity of inflammation or intestinal effects between the groups. Adverse effects on the lungs, liver, and pancreas were greater in the carbon dioxide group. All groups showed negative effects on the kidneys, regardless of the gas type. Although laparoscopic surgery has many advantages over open surgery, the type of gas used and the increased intra-abdominal pressure can cause adverse effects. However, we believe that these effects are likely transient and should be verified through clinical experience.
DISCUSSION AND CONCLUSION: In laparoscopic surgery, the choice of insufflation gas and elevated intra-abdominal pressure may induce transient adverse effects in various organs, highlighting the need for further clinical studies to substantiate these findings.
Keywords: Pneumoperitoneum, carbon dioxide, helium, laporoscopic surgery
Manuscript Language: English