Effect of laparoscopic abdominal surgery on splanchnic circulation: historical developments

Sinan Hatipoglu, Sami Akbulut, Filiz Hatipoglu, Ruslan Abdullayev, Sinan Hatipoglu, Sami Akbulut, Filiz Hatipoglu, Ruslan Abdullayev

Abstract

With the developments in medical technology and increased surgical experience, advanced laparoscopic surgical procedures are performed successfully. Laparoscopic abdominal surgery is one of the best examples of advanced laparoscopic surgery (LS). Today, laparoscopic abdominal surgery in general surgery clinics is the basis of all abdominal surgical interventions. Laparoscopic abdominal surgery is associated with systemic and splanchnic hemodynamic alterations. Inadequate splanchnic perfusion in critically ill patients is associated with increased morbidity and mortality. The underlying pathophysiological mechanisms are still not well understood. With experience and with an increase in the number and diversity of the resulting data, the pathophysiology of laparoscopic abdominal surgery is now better understood. The normal physiology and pathophysiology of local and systemic effects of laparoscopic abdominal surgery is extremely important for safe and effective LS. Future research projects should focus on the interplay between the physiological regulatory mechanisms in the splanchnic circulation (SC), organs, and diseases. In this review, we discuss the effects of laparoscopic abdominal surgery on the SC.

Keywords: Abdominal compartment syndrome; Intra-abdominal pressure; Laparoscopic abdominal surgery; Safe laparoscopic surgery; Splanchnic circulation.

References

    1. Ivatury RR, Diebel L, Porter JM, Simon RJ. Intra-abdominal hypertension and the abdominal compartment syndrome. Surg Clin North Am. 1997;77:783–800.
    1. Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE. Schwartz’s Principles of Surgery, Chapter 23: Arterial Disease. 9th ed. New York: The McGraw-Hill Companies; 2009.
    1. Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE. Schwartz’s Principles of Surgery, Chapter 24: Venous and Lymphatic Disease. 9th ed. New York: The McGraw-Hill Companies; 2009.
    1. Diebel LN, Dulchavsky SA, Brown WJ. Splanchnic ischemia and bacterial translocation in the abdominal compartment syndrome. J Trauma. 1997;43:852–855.
    1. Matheson PJ, Wilson MA, Garrison RN. Regulation of intestinal blood flow. J Surg Res. 2000;93:182–196.
    1. Yasuhara H. Acute mesenteric ischemia: the challenge of gastroenterology. Surg Today. 2005;35:185–195.
    1. Crissinger KD, Tso P. The role of lipids in ischemia/reperfusion-induced changes in mucosal permeability in developing piglets. Gastroenterology. 1992;102:1693–1699.
    1. Kelling G. Über oesophagoskopi, Gastrokopie und coelioskopie. Munch Med Wochenschr. 1902;49:21–24.
    1. Jacobaeus HC. Über die Möglichkeit die Zystoskopie bei undersuchung seröser Hihlunger anzuwenden. Munch Med Wochenschr. 1910;57:2090–2092.
    1. Hodgson C, McClelland RM, Newton JR. Some effects of the peritoneal insufflation of carbon dioxide at laparoscopy. Anaesthesia. 1970;25:382–390.
    1. Williams MD, Murr PC. Laparoscopic insufflation of the abdomen depresses cardiopulmonary function. Surg Endosc. 1993;7:12–16.
    1. Motew M, Ivankovich AD, Bieniarz J, Albrecht RF, Zahed B, Scommegna A. Cardiovascular effects and acid-base and blood gas changes during laparoscopy. Am J Obstet Gynecol. 1973;115:1002–1012.
    1. Lenz RJ, Thomas TA, Wilkins DG. Cardiovascular changes during laparoscopy. Studies of stroke volume and cardiac output using impedance cardiography. Anaesthesia. 1976;31:4–12.
    1. Harris MN, Plantevin OM, Crowther A. Cardiac arrhythmias during anaesthesia for laparoscopy. Br J Anaesth. 1984;56:1213–1217.
    1. Kelman GR, Swapp GH, Smith I, Benzie RJ, Gordon NL. Caridac output and arterial blood-gas tension during laparoscopy. Br J Anaesth. 1972;44:1155–1162.
    1. Banting S, Shimi S, Vander Velpen G, Cuschieri A. Abdominal wall lift. Low-pressure pneumoperitoneum laparoscopic surgery. Surg Endosc. 1993;7:57–59.
    1. Fletcher R. Arterial to end tidal CO2 tension differences. Anaesthesia. 1987;42:210–211.
    1. Hashimoto S, Hashikura Y, Munakata Y, Kawasaki S, Makuuchi M, Hayashi K, Yanagisawa K, Numata M. Changes in the cardiovascular and respiratory systems during laparoscopic cholecystectomy. J Laparoendosc Surg. 1993;3:535–539.
    1. Holzman M, Sharp K, Richards W. Hypercarbia during carbon dioxide gas insufflation for therapeutic laparoscopy: a note of caution. Surg Laparosc Endosc. 1992;2:11–14.
    1. Root B, Levy MN, Pollack S, Lubert M, Pathak K. Gas embolism death after laparoscopy delayed by “trapping” in portal circulation. Anesth Analg. 1978;57:232–237.
    1. Ricciardi R, Anwaruddin S, Schaffer BK, Quarfordt SH, Donohue SE, Wheeler SM, Gallagher KA, Callery MP, Litwin DE, Meyers WC. Elevated intrahepatic pressures and decreased hepatic tissue blood flow prevent gas embolus during limited laparoscopic liver resections. Surg Endosc. 2001;15:729–733.
    1. Ishizaki Y, Bandai Y, Shimomura K, Abe H, Ohtomo Y, Idezuki Y. Safe intraabdominal pressure of carbon dioxide pneumoperitoneum during laparoscopic surgery. Surgery. 1993;114:549–554.
    1. Ivankovich AD, Miletich DJ, Albrecht RF, Heyman HJ, Bonnet RF. Cardiovascular effects of intraperitoneal insufflation with carbon dioxide and nitrous oxide in the dog. Anesthesiology. 1975;42:281–287.
    1. Baratz RA, Karis JH. Blood gas studies during labaroscopy under general anesthesia. Anesthesiology. 1969;30:463–464.
    1. de Plater RM, Jones IS. Non-fatal carbon dioxide embolism during laparoscopy. Anaesth Intensive Care. 1989;17:359–361.
    1. Magno R, Medegård A, Bengtsson R, Tronstad SE. Acid-base balance during laparoscopy. The effects of intraperitoneal insufflation of carbon dioxide and nitrous oxide on acid-base balance during controlled ventilation. Acta Obstet Gynecol Scand. 1979;58:81–85.
    1. Gomar C, Fernandez C, Villalonga A, Nalda MA. Carbon dioxide embolism during laparoscopy and hysteroscopy. Ann Fr Anesth Reanim. 1985;4:380–382.
    1. Shimazutsu K, Uemura K, Auten KM, Baldwin MF, Belknap SW, La Banca F, Jones MC, McClaine DJ, McClaine RJ, Eubanks WS, et al. Inclusion of a nitric oxide congener in the insufflation gas repletes S-nitrosohemoglobin and stabilizes physiologic status during prolonged carbon dioxide pneumoperitoneum. Clin Transl Sci. 2009;2:405–412.
    1. Chiu AW, Chang LS, Birkett DH, Babayan RK. The impact of pneumoperitoneum, pneumoretroperitoneum, and gasless laparoscopy on the systemic and renal hemodynamics. J Am Coll Surg. 1995;181:397–406.
    1. Kubota K, Kajiura N, Teruya M, Ishihara T, Tsusima H, Ohta S, Nakao K, Arizono S. Alterations in respiratory function and hemodynamics during laparoscopic cholecystectomy under pneumoperitoneum. Surg Endosc. 1993;7:500–504.
    1. Wittgen CM, Andrus CH, Fitzgerald SD, Baudendistel LJ, Dahms TE, Kaminski DL. Analysis of the hemodynamic and ventilatory effects of laparoscopic cholecystectomy. Arch Surg. 1991;126:997–1000; discussion 1000-1.
    1. Hashikura Y, Kawasaki S, Munakata Y, Hashimoto S, Hayashi K, Makuuchi M. Effects of peritoneal insufflation on hepatic and renal blood flow. Surg Endosc. 1994;8:759–761.
    1. Harman PK, Kron IL, McLachlan HD, Freedlender AE, Nolan SP. Elevated intra-abdominal pressure and renal function. Ann Surg. 1982;196:594–597.
    1. Rubinson RM, Vasko JS, Doppman JL, Morrow AG. Inferior vena caval obstruction from increased intra-abdominal pressure. Experimental hemodynamic and angiographic observations. Arch Surg. 1967;94:766–770.
    1. Fitzgerald SD, Andrus CH, Baudendistel LJ, Dahms TE, Kaminski DL. Hypercarbia during carbon dioxide pneumoperitoneum. Am J Surg. 1992;163:186–190.
    1. Platell C, Hall J, Dobb G. Impaired renal function due to raised intraabdominal pressure. Intensive Care Med. 1990;16:328–329.
    1. Junghans T, Böhm B, Gründel K, Schwenk W, Müller JM. Does pneumoperitoneum with different gases, body positions, and intraperitoneal pressures influence renal and hepatic blood flow? Surgery. 1997;121:206–211.
    1. Blobner M, Bogdanski R, Kochs E, Henke J, Findeis A, Jelen-Esselborn S. Effects of intraabdominally insufflated carbon dioxide and elevated intraabdominal pressure on splanchnic circulation: an experimental study in pigs. Anesthesiology. 1998;89:475–482.
    1. Goh P, Tekant Y, Krishnan SM. Future developments in high-technology abdominal surgery: ultrasound, stereo imaging, robotics. Baillieres Clin Gastroenterol. 1993;7:961–987.
    1. Kozuch PL, Brandt LJ. Review article: diagnosis and management of mesenteric ischaemia with an emphasis on pharmacotherapy. Aliment Pharmacol Ther. 2005;21:201–215.
    1. Taylor LM. Management of visceral ischemic syndromes. In: Rutherford RB, editor. Vascular surgery. 5th ed. Philadelphia: W. B. Saunders; 2000. pp. 1501–1523.
    1. Sala-Blanch X, Fontanals J, Martínez-Palli G, Taurá P, Delgado S, Bosch J, Lacy AM, Visa J. Effects of carbon dioxide vs helium pneumoperitoneum on hepatic blood flow. Surg Endosc. 1998;12:1121–1125.
    1. Kron IL, Harman PK, Nolan SP. The measurement of intra-abdominal pressure as a criterion for abdominal re-exploration. Ann Surg. 1984;199:28–30.
    1. Thorington JM, Schmidt CF. A study of urinary out-put and blood pressure changes resulting in experimental ascites. Am J Med Sci. 1923;165:880–886.
    1. Guyton AC, Adkins LH. Quantitative aspects of the collapse factor in relation to venous return. Am J Physiol. 1954;177:523–527.
    1. Cooper C, Scalea TM. Abdominal Compartment Syndrome. In: Cameron JL, editor. Current Surgical Therapy. 6th ed. St Louis: Mosby; 1999. pp. 937–944.
    1. Burch JM, Moore EE, Moore FA, Franciose R. The abdominal compartment syndrome. Surg Clin North Am. 1996;76:833–842.
    1. Cheatham ML, Malbrain ML, Kirkpatrick A, Sugrue M, Parr M, De Waele J, Balogh Z, Leppäniemi A, Olvera C, Ivatury R, et al. Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome. II. Recommendations. Intensive Care Med. 2007;33:951–962.
    1. Onichimowski D, Podlińska I, Sobiech S, Ropiak R. [Measurement of the intra abdominal pressure in clinical practice] Anestezjol Intens Ter. 2010;42:107–112.
    1. Decker G. [Abdominal compartment syndrome] J Chir (Paris) 2001;138:270–276.
    1. Parmeggiani D, Gubitosi A, Ruggiero R, Docimo G, Atelli PF, Avenia N. The abdominal compartment syndrome: review, experience report and description of an innovative biological mesh application. Updates Surg. 2011;63:271–275.
    1. Sukhotnik I, Mogilner J, Hayari L, Brod V, Shaoul R, Slijper N, Bejar Y, Coran AG, Bitterman H. Effect of elevated intra-abdominal pressure and 100% oxygen on superior mesenteric artery blood flow and enterocyte turnover in a rat. Pediatr Surg Int. 2008;24:1347–1353.
    1. Ivatury RR, Porter JM, Simon RJ, Islam S, John R, Stahl WM. Intra-abdominal hypertension after life-threatening penetrating abdominal trauma: prophylaxis, incidence, and clinical relevance to gastric mucosal pH and abdominal compartment syndrome. J Trauma. 1998;44:1016–121; discussion 1016-121;.
    1. Maxwell RA, Fabian TC, Croce MA, Davis KA. Secondary abdominal compartment syndrome: an underappreciated manifestation of severe hemorrhagic shock. J Trauma. 1999;47:995–999.
    1. Bailey J, Shapiro MJ. Abdominal compartment syndrome. Crit Care. 2000;4:23–29.
    1. Jakimowicz J, Stultiëns G, Smulders F. Laparoscopic insufflation of the abdomen reduces portal venous flow. Surg Endosc. 1998;12:129–132.
    1. Latimer FG, Eades SC, Pettifer G, Tetens J, Hosgood G, Moore RM. Cardiopulmonary, blood and peritoneal fluid alterations associated with abdominal insufflation of carbon dioxide in standing horses. Equine Vet J. 2003;35:283–290.
    1. Fuller J, Ashar BS, Carey-Corrado J. Trocar-associated injuries and fatalities: an analysis of 1399 reports to the FDA. J Minim Invasive Gynecol. 2005;12:302–307.
    1. Itani KM, Neumayer L, Reda D, Kim L, Anthony T. Repair of ventral incisional hernia: the design of a randomized trial to compare open and laparoscopic surgical techniques. Am J Surg. 2004;188:22S–29S.
    1. Ishizaki Y, Bandai Y, Shimomura K, Abe H, Ohtomo Y, Idezuki Y. Changes in splanchnic blood flow and cardiovascular effects following peritoneal insufflation of carbon dioxide. Surg Endosc. 1993;7:420–423.
    1. Richmond BK, Thalheimer L. Laparoscopy associated mesenteric vascular complications. Am Surg. 2010;76:1177–1184.
    1. Sato K, Wakusawa R, Sato T, Chiba T, Abe Y, Abe M. [Hepatic blood flow decreases during laparoscopic cholecystectomy] Masui. 1996;45:824–828.
    1. Schäfer M, Sägesser H, Reichen J, Krähenbühl L. Alterations in hemodynamics and hepatic and splanchnic circulation during laparoscopy in rats. Surg Endosc. 2001;15:1197–1201.
    1. Richter S, Olinger A, Hildebrandt U, Menger MD, Vollmar B. Loss of physiologic hepatic blood flow control (“hepatic arterial buffer response”) during CO2-pneumoperitoneum in the rat. Anesth Analg. 2001;93:872–877.
    1. Schilling MK, Redaelli C, Krähenbühl L, Signer C, Büchler MW. Splanchnic microcirculatory changes during CO2 laparoscopy. J Am Coll Surg. 1997;184:378–382.
    1. Bickel A, Loberant N, Bersudsky M, Goldfeld M, Ivry S, Herskovits M, Eitan A. Overcoming reduced hepatic and renal perfusion caused by positive-pressure pneumoperitoneum. Arch Surg. 2007;142:119–24; discussion 125.
    1. Sikuler E, Kravetz D, Groszmann RJ. Evolution of portal hypertension and mechanisms involved in its maintenance in a rat model. Am J Physiol. 1985;248:G618–G625.
    1. Sumanovski LT, Battegay E, Stumm M, van der Kooij M, Sieber CC. Increased angiogenesis in portal hypertensive rats: role of nitric oxide. Hepatology. 1999;29:1044–1049.
    1. Vallance P, Moncada S. Hyperdynamic circulation in cirrhosis: a role for nitric oxide? Lancet. 1991;337:776–778.
    1. Pizcueta MP, Piqué JM, Bosch J, Whittle BJ, Moncada S. Effects of inhibiting nitric oxide biosynthesis on the systemic and splanchnic circulation of rats with portal hypertension. Br J Pharmacol. 1992;105:184–190.
    1. Groszmann RJ. Vasodilatation and hyper dynamic circulatory state in chronic liver disease. In: Bosch J, Groszmann RJ, editors. Portal hypertension. Patophysiology and treatment. Oxford: Blackwell Scientific Publications; 1994. pp. 17–26.
    1. Rosendaal FR. Risk factors for venous thrombotic disease. Thromb Haemost. 1999;82:610–619.
    1. Lobo Martínez E, Meroño Carvajosa E, Sacco O, Martínez Molina E. [Embolectomy in mesenteric ischemia] Rev Esp Enferm Dig. 1993;83:351–354.
    1. Inderbitzi R, Wagner HE, Seiler C, Stirnemann P, Gertsch P. Acute mesenteric ischaemia. Eur J Surg. 1992;158:123–126.
    1. Schneider TA, Longo WE, Ure T, Vernava AM. Mesenteric ischemia. Acute arterial syndromes. Dis Colon Rectum. 1994;37:1163–1174.
    1. Sato K, Kawamura T, Wakusawa R. Hepatic blood flow and function in elderly patients undergoing laparoscopic cholecystectomy. Anesth Analg. 2000;90:1198–1202.
    1. Rosenthal RA. Small-bowel disorders and abdominal wall hernia in the elderly patient. Surg Clin North Am. 1994;74:261–291.
    1. Korotinski S, Katz A, Malnick SD. Chronic ischaemic bowel diseases in the aged--go with the flow. Age Ageing. 2005;34:10–16.
    1. Rist M, Hemmerling TM, Rauh R, Siebzehnrübl E, Jacobi KE. Influence of pneumoperitoneum and patient positioning on preload and splanchnic blood volume in laparoscopic surgery of the lower abdomen. J Clin Anesth. 2001;13:244–249.
    1. Yokoyama Y, Alterman DM, Sarmadi AH, Baveja R, Zhang JX, Huynh T, Clemens MG. Hepatic vascular response to elevated intraperitoneal pressure in the rat. J Surg Res. 2002;105:86–94.
    1. Bready LL. Anesthesia for laparoscopic surgery. Curr Rev Clin Anesth. 1995;15:133.
    1. Kashtan J, Green JF, Parsons EQ, Holcroft JW. Hemodynamic effect of increased abdominal pressure. J Surg Res. 1981;30:249–255.

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