HISTOPATHOLOGICAL CHANGES OF THE PERITONE UM DUE TO LAPAROSCOPIC SURGERY

We took peritoneum specimens of 71 patients who either underwent a lap aroscopic operation with or without pneumoperitoneum or a conventional open surgical procedure to detect histopathological changes of the pe ritoneum under clinical conditions. After staining the 71 specimens (H E, Goldner, CD31) they were examined microscopically and the following changes could be detected: nine out of 16 specimens which were taken after laparoscopical procedures which lasted longer than 90 min showed granulocyte infiltration into the vessel wall of the peritoneal vesse ls or into the connective tissue. A relative increase of connective ti ssue portion due to increased tissue pressure was found to be characte ristic of laparoscopy with pneumoperitoneum. Bleeding into the tissue caused by haemostasis was found in 70% of the specimens taken after la paroscopy with pneumoperitoneum and only in one specimen taken after g asless laparoscopy, and in one case after conventional surgery. We thi nk that both the bleeding as well as granulocyte migration into the ve ssel walls are a sign of the beginning of an inflammatory reaction cau sed by a local circulatory disorder due to the increased intraabdomina l pressure during laparoscopy with pneumoperitoneum.