Elsevier

Surgery

Volume 129, Issue 4, April 2001, Pages 385-389
Surgery

Surgical Research Review
Effect of laparoscopy on intra-abdominal blood flow*

https://doi.org/10.1067/msy.2001.110224Get rights and content

Abstract

Surgery 2001;129:385-9.

Section snippets

Alterations of hepatic blood flow

Impairment of the hepatic circulation, in particular portal blood flow, induced by intra-abdominal insufflation of different gases (eg, CO2, helium, and argon) or fluid has been documented in various experimental and clinical studies. Measurements of blood flow were performed either by using direct methods (Doppler and transit-time ultrasonography or intravascular catheters) or indirect methodology (indocyanine green clearance, thermodilution and γ-labeled microsphere technique). Table I

Alterations of splanchnic and renal blood flow

As shown in Table II, intestinal circulation of hollow viscus organs (stomach and small and large bowel) and of solid organs (liver, spleen, pancreas, and kidneys) reveals a decrease in blood flow during laparoscopy with increased IAP similar to that of hepatic blood flow.8, 9, 12, 16, 17

. Alterations of splanchnic blood flow during CO2-laparoscopy

StudyModelMethodIAP (mm Hg)Mesenteric arterial flowGastric (mucosal) pHHollow/solid organ blood flowReversibility
Blobner et al16PigsIv catheter4-12

Conclusion

The benefit offered by laparoscopy is the minimal access into the peritoneal cavity, the main impact of which involves the postoperative recovery. The surgical procedure itself remains unchanged. However, the technique of laparoscopic surgery necessitates methodological requirements that may be associated with adverse effects on the patient's intraoperative physiology. Numerous studies using various animal and human models and sophisticated measurement techniques have shown a variety of adverse

References (22)

  • S Takagi

    Hepatic and portal vein blood flow during carbon dioxide pneumoperitoneum for laparoscopic hepatectomy

    Surg Endosc

    (1998)
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    *

    Reprint requests: Lukas Krähenbühl, MD, Department of Visceral and Transplantation Surgery, University of Zurich, Rämistrasse, CH-8091 Zurich, Switzerland.

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