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  • Title: The effects of carbon dioxide pneumoperitoneum on ovarian blood flow, oxidative stress markers, and morphology during laparoscopy: a rabbit model.
    Author: Guven S, Muci E, Unsal MA, Yulug E, Alver A, Kadioglu Duman M, Mentese A.
    Journal: Fertil Steril; 2010 Mar 01; 93(4):1327-32. PubMed ID: 19081089.
    Abstract:
    OBJECTIVE: To determine the effect of CO(2) pneumoperitoneum on the ovaries in an experimental pneumoperitoneum model. DESIGN: Experimental controlled study. SETTING: University hospital. PATIENT(S): Sixteen adult female conventional rabbits. INTERVENTION(S): Group I (8 rabbits) was not subjected to intra-abdominal pressure (IAP). In group II (8 rabbits), IAP insufflation was performed at 12 mm Hg. In total, 60 minutes of pneumoperitoneum and 10 minutes of reperfusion were maintained. Ovarian blood flow (OBF) was studied using laser Doppler flowmetry. The time points of OBF measurements were as follows: OBFbaseline, 10 minutes before insufflation; OBF30min, 30 minutes after pneumoperitoneum; OBF60min, 60 minutes after pneumoperitoneum; and OBFreperfusion, 10 minutes after pneumoperitoneum desufflation. Mean OBF changes during CO(2) pneumoperitoneum (OBFmean) were also assessed. MAIN OUTCOME MEASURE(S): Blood perfusion units, tissue malondialdehyde values, and histopathologic damage scores. RESULT(S): In group II, mean OBF values were significantly lower than in group I, especially for OBF30min, OBF60min, OBFreperfusion, and OBFmean. The mean tissue malondialdehyde value for group II was significantly higher than in the control group (104.48 +/- 20.07 nmol/g vs. 64.12 +/- 8.77 nmol/g, respectively). Compared with group I, in group II histologic specimens of the ovaries had higher scores for follicular cell degeneration, vascular congestion, hemorrhage, and inflammatory cell infiltration. CONCLUSION(S): Pneumoperitoneum, even at normal IAP levels, leads to significant oxidative stress-induced biochemical and histologic damage to the ovaries.
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