Saline-filled laparoscopic surgery: A basic study on partial hepatectomy in a rabbit model

Abstract

Background: There is still a poor understanding of the effects of pneumoperitoneum with insufflation of carbon dioxide gas (CO₂) on malignant cells, and pneumoperitoneum has a negative impact on cardiopulmonary responses. A novel saline-filled laparoscopic surgery (SAFLS) is proposed, and the technical feasibility of performing saline-filled laparoscopic partial hepatectomy (LPH) was evaluated in a rabbit model. Material and methods: Twelve LPH were performed in rabbits, with six procedures performed using an ultrasonic device with CO₂ pneumoperitoneum (CO₂ group) and six procedures performed using a bipolar resectoscope (RS) in a saline-filled environment (saline group). Resection time, CO₂ and saline consumption, vital signs, blood gas analysis, complications, interleukin-1 beta (IL-1β) and C-reactive protein (CRP) levels were measured. The effectiveness of the resections was evaluated by the pathological findings. Results: LPH was successfully performed with clear observation by irrigation and good control of bleeding by coagulation with RS. There were no significant differences in all perioperative values, IL-1βand CRP levels between the two groups. All pathological specimens of the saline group showed that the resected lesions were coagulated and regenerated as well as in the CO₂ group. Conclusions: SAFLS is feasible and provides a good surgical view with irrigation and identification of bleeding sites.

Key words:

• Laparoscopic surgery
• saline
• hepatectomy
• rabbit model
• resectoscope

Acknowledgments

That authors would like to thank Professor A. Oe (Kanazawa University Graduate School of Medical Science Molecular and Cellular Pathology), T. Ishizuka, K. Mikami (OLYMPUS), K. Chiba, H. Komiyama, S. Kitamura (AMCO), Y. Kita (MC Medical, Inc., Tokyo, Japan), and S. Ishino (SRL, Inc., Tokyo, Japan) for providing technical support. This work was supported by JSPS KAKENHI Grant Number 23659642.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.