The effect of intra‐abdominal pressure on the generation of 8‐iso prostaglandin F2α during laparoscopy in rabbits

• Published in: Human reproduction (Oxford) 2003-10, Vol.18 (10), p.2181-2188
• Main Authors: de Souza, Ângela M.Bentes, Wang, Chi Chiu, Chu, Ching Yan, Lam, Po Mui, Rogers, Michael Scott
• Format: Article
• Language: English
• Subjects: Key words: adhesion formation/intra‐abdominal pressure/ischaemia/isoprostanes/laparoscopy
• ISSN: 0268-1161; 1460-2350
• DOI: 10.1093/humrep/deg405

BACKGROUND: Carbon dioxide pneumoperitoneum induces peritoneal oxidative stress. The aim of this study was to verify the effect of intra‐abdominal pressure on oxidative stress in the peritoneum and on post‐operative adhesion formation. METHODS: Forty‐one rabbits underwent laparoscopic surgery: either gasless, or with CO2‐pneumoperitoneum at pressures of 5, 10 or 15 mmHg. Serial parietal peritoneal biopsies were taken at various time‐points: immediately after reaching the abdominal cavity, 30, 60, 90 and 120 min afterwards, and 15 min after abdominal desufflation. 8‐iso prostaglandin F2α (8‐iso PGF2α), a marker of oxidative stresss, was assayed by enzyme immunoassay and adhesion formation was scored by second‐look laparoscopy on day 14. RESULTS: The gasless group showed no significant changes in 8‐iso PGF2α. Conversely, significant changes occurred in CO2‐pneumoperitoneum in a time‐ and pressure‐dependent manner. Adhesions developed only in the CO2‐pneumoperitoneum groups, and total adhesion score was correlated with the amount of CO2 insufflated and intra‐abdominal pressure, but not with 8‐iso PGF2α, which was correlated with intra‐abdominal pressure. CONCLUSION: Intra‐abdominal pressure increased 8‐iso PGF2α in the parietal peritoneum in a graded fashion, whilst gasless laparoscopy had no impact. It also influenced the frequency and severity of adhesion formation, but no causal link was found between 8‐iso PGF2α and post‐operative adhesion formation.