INTRAPERITONEAL CELL-MOVEMENT DURING ABDOMINAL CARBON-DIOXIDE INSUFFLATION AND LAPAROSCOPY - AN IN-VIVO MODEL

PURPOSE: Possible mechanisms of movement of malignant cells within the peritoneal cavity during CO2 insufflation and laparoscopy involve dir ect transfer via laparoscopic instruments or dispersion of cells by CO 2 or water vapor. An in vivo model has been developed to study these m echanisms. METHODS: Laparoscopy was performed on an animal model (dome stic white pig). Cells derived from colorectal cancer cell line Lim 12 15 were injected to lie free within the peritoneal cavity. A polycarbo nate filter system with a 5-micron pore diameter was used to examine C O2 expelled from the peritoneal cavity, during laparoscopy and manipul ation of abdominal viscera, for malignant cells. Laparoscopic instrume nts and laparoscopic ports were washed independently, and fluid nas ce ntrifuged and examined for malignant cells. RESULTS: Malignant cells m ere identified on 1 of 30 filters used to examine exhaust carbon dioxi de. Malignant cells also were identified from 2 of 10 washings from la paroscopic ports and from 4 of 10 washings of laparoscopic instruments . CONCLUSIONS: These results suggest that movement of cells throughout the peritoneal cavity during laparoscopy is via contaminated instrume nts, but local cell movement by dispersion possibly within water vapor from the port may also occur.