Is intestinal ischemia a risk of laparoscopy? An experimental study in rabbits

Background and purpose:; In the literature, there are few reports documenti ng intra-abdominal organ necrosis following laparoscopic procedures. This e xperimental study was planned to investigate whether intestinal ischemia de velops during laparoscopic procedures and if laparoscopy could cause intest inal necrosis. Material and Methods: Two experimental groups, each consisting of 10 adult New-Zealand rabbits; were used in this study. The first group comprised the study group which had pneumoperitoneum, the second group comprised the nor mal animals serving as the controls. A cervical tracheostomy was performed to achieve successful general anesthesia in;both groups. In the study group , intraperitoneal CO2 insufflation was carried out and intraabdominal press ure (IAP) was adjusted so as not to exceed the arterial blood pressure. Aft er 20 min high IAP period, the intraabdominal gas was aspirated. Five minut es later, samples of both small intestine and colon tissue were taken. In t he control group, tissue samples were taken 25 min after anesthesia was ach ieved. Xanthine oxidase (XO) and malondialdehyde (MDA) levels were measured as indicators of intestinal ischemia and lipid peroxidation in the intesti nal tissues. Statistical analysis was done to compare the XO and MDA levels of the small intestines and colons of both groups. Results: The mean colonic XO levels were 1.323 +/- 1.17 and 0.217 +/- 0.27 (U/mg protein) in study and control groups, respectively. This difference w as statistically significant (t = 2.60, p < 0.05). The other comparisons wi th regard to XO and MDA levels were statistically not significant. Conclusion: Our results demonstrate that intraperitoneal CO, insufflation i n which intraabdominal pressure was adjusted to be lower than arterial bloo d pressure may affect oxygenization of the colon.