Abstract:
Background: Laparoscopic procedures under certain pressure have the potential to cause intra-abdominal adhesions.
However, the pathomechanism of this disorder is unknown. Release of mast cell mediators due to mast
cell degranulation is thought to be the cause.
Materials and methods: Thirty male Sprague-Dawley rats were grouped into five groups (n = 6 per group): one
control group and four intervention groups to which 60 min insufflation was performed using carbon dioxide at
5, 8, 10 and 12 mmHg. Seven days after laparoscopy, we euthanized and evaluated the levels of histamine,
tryptase, and chymase of peritoneal fluid, the thickness of ECM of peritoneal tissue, and intraabdominal adhesion
scoring system.
Results: Histamine and tryptase levels in peritoneal fluid were significantly higher at the 10- and 12 mm Hg
intervention compared to control (histamine: 0.50 ± 0.35 vs. 0.41 ± 0.41 vs. 0.04 ± 0.02 ng/mL, respectively;
and tryptase: 0.69 ± 0.11 vs. 0.65 ± 0.05 vs. 0.48 ± 0.02 ng/ml respectively). The ECM was significantly thicker
in the intervention groups at 10- and 12-mm Hg compared to control (71.3 [66.7–85.2] vs. 48.4 [34.5–50.3] vs.
10.25 [8.7–12.1] μm, respectively). Moreover, the intra-abdominal scoring was also significantly higher in the
intervention groups at 10- and 12 mm Hg compared to control (4 [0–4] vs. 4.5 [4–5], vs. 0, respectively).
Conclusions: Laparoscopic procedures increase the release of mast cell mediators in peritoneal fluid, the thickness
of ECM and intraabdominal adhesion scoring in rats, implying that it might increase the possibility of intrabdominal
adhesion in humans.
