LAPAROSCOPIC PNEUMODISSECTION - A UNIQUE MEANS OF TISSUE DISSECTION

Purpose: To study the acute and chronic tissue effects of using high p ressure CO2 to dissect tissues during laparoscopic procedures. Materia ls and Methods: A 5-mm. laparoscopic pneumodissector, capable of deliv ering brief bursts of high pressure CO2 (20 to 100 psi), was discharge d on a variety of porcine tissues including the renal hilum. Acute and chronic histological sections, intraoperative blood gases and periope rative renal scans were obtained. Results: The only tissue with signif icant acute damage was the spleen. Acute changes in other tissues were minimal; long-term studies revealed no discernible damage to these sa me tissues. Intraoperative blood gases revealed no significant changes in the serum pCO(2) or pH. Likewise, there was no renal damage discer nible by renal scans. Conclusions: Pneumodissection at 50 psi is a saf e method for dissecting the porcine kidney and the vessels of the rena l hilum. Clinical studies are pending.