Peritoneal pH during laparoscopy is dependent on ambient gas environment: helium and nitrous oxide do not cause peritoneal acidosis

Abstract

Parietal peritoneal pH during laparoscopy was highly dependent on the ambient gas environment. The effect of intraabdominal pressure on parietal peritoneal pH was of minor significance. Carbon dioxide caused a slight worsening of parietal peritoneal acidosis at higher intraabdominal pressure, whereas, N(2)O, He, and Lift did not cause parietal peritoneal acidosis.

Peritoneal and systemic pH during pneumoperitoneum with CO2 and helium in a pig model

“…This temporary acidic environment seems not to be reversed until the gas is finally evacuated and its systemic effects seem to remain even after cessation of exposure. One might speculate that local hypoxia and abdominal wall distension adds an acidifying effect, but Wong et al [8] found in a porcine model that the type of gas (CO 2 , helium or N 2 O), and not the intra-abdominal gas pressure determined peritoneal pH. They also reported peritoneal acidification with CO 2 at the same levels as in the current experiment.…”

“…An alkalotic peritoneal response to helium pneumoperitoneum was also noted by Wong et al in their porcine model [8], but the mechanism remains unclear. What the clinical implications of slight peritoneal alkalisation might be are not known, and need further investigation.…”

Exposure to carbon dioxide and helium reduces in vitro proliferation of pediatric tumor cells

“…The behavior of pediatric tumor cells has not been investigated in this respect in vitro. Our data indicate that the exposure to CO 2 decreases the mitochondrial activity of some pediatric Helium has been suggested for alternative use for pneumoperitoneum to prevent CO 2 effects such as local acidosis and systemic hypercapnia [4,19,28]. In addition, a beneficial effect of helium versus CO 2 on the growth of rat mammary adenocarcinoma cells was shown in vitro [18].…”

Optimizing working-space in laparoscopy: measuring the effect of mechanical bowel preparation in a porcine model

“…It has a longer learning curve [5], increases operating times and costs [2,3], and it has the disadvantages of a CO 2 pneumoperitoneum [6][7][8][9][10][11][12][13][14][15][16][17][18]. Various solutions have been proposed to overcome the consequences of CO 2 pneumoperitoneum [19][20][21][22][23][24]. Nevertheless, obtaining enough working space is essential for good view and handling of instruments [25][26][27].…”