Helium gas pneumoperitoneum can improve the recovery of gastrointestinal motility after a laparoscopic operation

Abstract

The use of laparoscopic surgery contributes to faster recovery of postoperative gastrointestinal motility. Several authors have demonstrated the benefits of laparoscopic surgery using carbon dioxide (CO₂) pneumoperitoneum. However, there have been few investigations of the effects of other insufflation gases on gastrointestinal motility. The aim of this study was to investigate the effect of CO₂ and helium pneumoperitoneum on the recovery of postoperative gastrointestinal motility. For this study, male Sprague‐Dawley rats were divided into four groups: control, CO₂ insufflation (10 mmHg), helium insufflation (10 mmHg) and open laparotomy for one hour. Arterial pH values and PaCO₂ were measured after surgery. Gastrointestinal motility was evaluated by quantifying the distribution of markers placed into the stomach at the end of procedures until 24 hours after surgery. In the CO₂ insufflation group, the arterial pH value was significantly lower than that of the helium insufflation group, and significant hypercapnia persisted until six hours after surgery. The gastric emptying and transit time was significantly prolonged in the CO₂ group compared with the helium insufflation group.

This study demonstrates that helium pneumoperitoneum can improve the recovery of postoperative gastrointestinal motility because of the reduction of hypercapnia and a tendency to suffer acidosis compared with CO₂ pneumoperitoneum.

• pneumoperitoneum
• helium
• carbon dioxide
• gastrointestinal motility