The effect of timing of pneumoperitoneum on the inflammatory response

Laparoscopic surgery and the parasympathetic nervous system

“…With respect to CO 2 -mediated attenuation of TNF-a production, our findings are consistent with those of our previous work [3,13]. Insufflation with CO 2 was the only experimental group that consistently yielded similar TNF-a levels between saline-and atropine-treated animals.…”

“…ability of CO 2 to attenuate the lipopolysaccharide (LPS) and cecal ligation and puncture-induced acute phase inflammatory response [2,3,12,14]. Moreover, we have shown that CO 2 pneumoperitoneum increases survival in an animal model of sepsis [13].…”

Carbon dioxide pneumoperitoneum prevents mortality from sepsis

“…Because laparoscopy is known to attenuate humoral aspects of the inflammatory response [3,18,27], and , or helium pneumoperitoneum (He). Insufflation with CO 2 increased plasma interleukin-10 (IL-10) levels by 35% compared with helium pneumoperitoneum, and by 34% compared with anesthesia control.…”

Immediate peritoneal response to bacterial contamination during laparoscopic surgery

“…During open surgery, the most important components of injury are the amount of injured tissue (wound size), visceral traction, and desiccation and temperature changes. During LS, the injury related to the wound is reduced, but other components may develop either as a consequence of abdominal wall and peritoneal distension or in relation to the gas used and the duration of the procedure [2]. CO 2 pneumoperitoneum induces morphologic changes in the peritoneal surface, increasing intercellular space and cellular burgeoning [22], and these changes are more pronounced when peritoneal contamination is added [5,33,40].…”