Characteristic alterations of the peritoneum after carbon dioxide pneumoperitoneum

Objective: Any route of entry into the abdomen contributes to alterations o f the intraperitoneal organs with different clinical consequences. Characte ristic alterations of the peritoneum after CO2 pneumoperitoneum used in lap aroscopic surgery is examined. Methods: A CO2 pneumoperitoneum with an intraperitoneal pressure of 6 mmHg was applied for 30 min in 32 nude mice. In the course of 4 days, the animal s were killed and the peritoneal surface of the abdominal wall was studied by means of scanning electron microscopy. Results: Already 2 h after release of the pneumoperitoneum, mesothelial cel ls were bulging up. The intercellular clefts thereby increased in size, and the underlying basal lamina became visible. This reaction peaked after 12 h, Subsequently, peritoneal macrophages and lymphocytes filled all gaps, th ereby recovering the basal lamina. Conclusion: The morphologic integrity of the peritoneum is temporarily dist urbed by a CO2 pneumoperitoneum.