Evaluation of the therapeutic potential of laparoscopy in different modelsof peritonitis in the rat

With ongoing development of minimally invasive surgery the laparoscopic tec hniques are increasingly used also in patients with intra-abdominal inflamm atory diseases. The systemic sequelae of laparoscopy are not yet clear. In this study, we investigated three experimental models of peritonitis in rat s (cecal ligation and puncture n = 14, cecal stent peritonitis n = 14, impl antation of a standardized fecal inoculum n = 18) concerning the therapeuti c potential of laparoscopy, reproducibility of the results and clinical rel evance (elimination of the inflammatory focus, intraperitoneal modulation o f inflammation). The peritonitis model of implantation of a standardized fe cal inoculum was shown to be the experimental mo del with the closest clini cal relevance. In this technically simple, reproducible model, the primary inflammatory focus can be eliminated by laparoscopic lavage. A significant difference (p < 0.002) of survival between the groups with and without lapa roscopic lavage was found. In addition, the intraperitoneal application of drugs is possible in order to modulate peritoneal and systemic inflammation .