{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T03:42:51Z","timestamp":1740109371837,"version":"3.37.3"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T00:00:00Z","timestamp":1636070400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T00:00:00Z","timestamp":1636070400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"The Swiss National Foundation","award":["3200-061486.00"],"award-info":[{"award-number":["3200-061486.00"]}]},{"name":"The Swiss Foundation for Molecular Tumour Research"},{"DOI":"10.13039\/501100006447","name":"University of Zurich","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006447","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background and aims<\/jats:title>\n                <jats:p>This experimental study assesses the influence of different gases and insufflation pressures on the portal, central-venous and peripheral-arterial pH during experimental laparoscopy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Firstly, 36 male WAG\/Rij rats were randomized into six groups (<jats:italic>n<\/jats:italic>\u2009=\u20096) spontaneously breathing during anaesthesia: laparoscopy using carbon dioxide or helium at 6 and 12\u00a0mmHg, gasless laparoscopy and laparotomy. 45 and 90\u00a0min after setup, blood was sampled from the portal vein, vena cava and the common femoral artery with immediate blood gas analysis. Secondly, 12 animals were mechanically ventilated at physiological arterial pH during 90\u00a0min of laparotomy (<jats:italic>n<\/jats:italic>\u2009=\u20096) or carbon dioxide laparoscopy at 12\u00a0mmHg (<jats:italic>n<\/jats:italic>\u2009=\u20096) with respective blood gas analyses.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Over time, in spontaneously breathing rats, carbon dioxide laparoscopy caused significant insufflation pressure-dependent portal acidosis (pH at 6\u00a0mmHg, 6.99 [6.95\u20137.04] at 45\u00a0min and 6.95 [6.94\u20136.96] at 90\u00a0min, pH at 12\u00a0mmHg, 6.89 [6.82\u20136.90] at 45\u00a0min and 6.84 [6.81\u20136.87] at 90\u00a0min; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) compared to laparotomy (portal pH 7.29 [7.23\u20137.30] at 45\u00a0min and 7.29 [7.20\u20137.30] at 90\u00a0min; <jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). Central-venous and peripheral-arterial acidosis was significant but less severely reduced during carbon dioxide laparoscopy. Laparotomy, helium laparoscopy and gasless laparoscopy showed no comparable acidosis in all vessels. Portal and central-venous acidosis during carbon dioxide laparoscopy at 12\u00a0mmHg was not reversible by mechanical hyperventilation maintaining a physiological arterial pH (pH portal 6.85 [6.84\u20136.90] (<jats:italic>p<\/jats:italic>\u2009=\u20090.004), central-venous 6.93 [6.90\u20136.99] (<jats:italic>p<\/jats:italic>\u2009=\u20090.004), peripheral-arterial 7.29 [7.29\u20137.31] (<jats:italic>p<\/jats:italic>\u2009=\u20090.220) at 90\u00a0min; Wilcoxon\u2013Mann\u2013Whitney test).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Carbon dioxide laparoscopy led to insufflation pressure-dependent severe portal and less severe central-venous acidosis not reversible by mechanical hyperventilation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00464-021-08810-6","type":"journal-article","created":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T21:34:29Z","timestamp":1636148069000},"page":"4701-4711","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Severe portal and systemic acidosis during CO2-laparoscopy compared to helium or gasless laparoscopy and laparotomy in a rodent model: an experimental study"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4443-7231","authenticated-orcid":false,"given":"Devdas T.","family":"Inderbitzin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias U.","family":"Mueller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grischa","family":"Marti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Eichenberger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beno\u00eet","family":"Fellay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Luc","family":"Magnin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Kraehenbuehl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,11,5]]},"reference":[{"key":"8810_CR1","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1007\/s00464-002-9108-z","volume":"17","author":"R Costi","year":"2003","unstructured":"Costi R, Denet C, Sarli L, Perniceni T, Roncoroni L, Gayet B (2003) Laparoscopy in the last decade of the millennium: have we really improved? Surg Endosc 17:791\u2013797","journal-title":"Surg Endosc"},{"key":"8810_CR2","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1097\/00000658-199509000-00004","volume":"222","author":"LC Martin","year":"1995","unstructured":"Martin LC, Puente I, Sosa JL, Bassin A, Breslaw R, McKenney MG, Ginzburg E, Sleeman D (1995) Open versus laparoscopic appendectomy. A prospective randomized comparison. Ann Surg 222:256\u2013261 (discussion 261\u2013252)","journal-title":"Ann Surg"},{"key":"8810_CR3","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD009569","author":"Y Cheng","year":"2013","unstructured":"Cheng Y, Lu J, Xiong X, Wu S, Lin Y, Wu T, Cheng N (2013) Gases for establishing pneumoperitoneum during laparoscopic abdominal surgery. Cochrane Database Syst Rev. https:\/\/doi.org\/10.1002\/14651858.CD009569","journal-title":"Cochrane Database Syst Rev"},{"key":"8810_CR4","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1111\/j.1365-2044.1993.tb06949.x","volume":"48","author":"GI Bardoczky","year":"1993","unstructured":"Bardoczky GI, Engelman E, Levarlet M, Simon P (1993) Ventilatory effects of pneumoperitoneum monitored with continuous spirometry. Anaesthesia 48:309\u2013311","journal-title":"Anaesthesia"},{"key":"8810_CR5","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1007\/s11605-008-0662-0","volume":"13","author":"JE Grabowski","year":"2009","unstructured":"Grabowski JE, Talamini MA (2009) Physiological effects of pneumoperitoneum. J Gastrointest Surg 13:1009\u20131016","journal-title":"J Gastrointest Surg"},{"key":"8810_CR6","doi-asserted-by":"publisher","first-page":"984","DOI":"10.1001\/archsurg.1995.01430090070022","volume":"130","author":"JP McDermott","year":"1995","unstructured":"McDermott JP, Regan MC, Page R, Stokes MA, Barry K, Moriarty DC, Caushaj PF, Fitzpatrick JM, Gorey TF (1995) Cardiorespiratory effects of laparoscopy with and without gas insufflation. Arch Surg 130:984\u2013988","journal-title":"Arch Surg"},{"key":"8810_CR7","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1016\/S0094-0143(05)70110-5","volume":"27","author":"MD Dunn","year":"2000","unstructured":"Dunn MD, McDougall EM (2000) Renal physiology. Laparoscopic considerations. Urol Clin North Am 27:609\u2013614","journal-title":"Urol Clin North Am"},{"key":"8810_CR8","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1016\/S1072-7515(02)01321-2","volume":"195","author":"NT Nguyen","year":"2002","unstructured":"Nguyen NT, Perez RV, Fleming N, Rivers R, Wolfe BM (2002) Effect of prolonged pneumoperitoneum on intraoperative urine output during laparoscopic gastric bypass. J Am Coll Surg 195:476\u2013483","journal-title":"J Am Coll Surg"},{"key":"8810_CR9","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1097\/01.sla.0000151791.93571.70","volume":"241","author":"NT Nguyen","year":"2005","unstructured":"Nguyen NT, Wolfe BM (2005) The physiologic effects of pneumoperitoneum in the morbidly obese. Ann Surg 241:219\u2013226","journal-title":"Ann Surg"},{"key":"8810_CR10","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1007\/s004649900482","volume":"11","author":"CN Gutt","year":"1997","unstructured":"Gutt CN, Heinz P, Kaps W, Paolucci V (1997) The phagocytosis activity during conventional and laparoscopic operations in the rat. A preliminary study. Surg Endosc 11:899\u2013901","journal-title":"Surg Endosc"},{"key":"8810_CR11","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1016\/j.surg.2007.02.017","volume":"142","author":"EJ Hanly","year":"2007","unstructured":"Hanly EJ, Aurora AA, Shih SP, Fuentes JM, Marohn MR, De Maio A, Talamini MA (2007) Peritoneal acidosis mediates immunoprotection in laparoscopic surgery. Surgery 142:357\u2013364","journal-title":"Surgery"},{"key":"8810_CR12","doi-asserted-by":"publisher","first-page":"1693","DOI":"10.1007\/s00464-009-0831-6","volume":"24","author":"M Yoshida","year":"2010","unstructured":"Yoshida M, Ikeda S, Sumitani D, Takakura Y, Yoshimitsu M, Shimomura M, Noma M, Tokunaga M, Okajima M, Ohdan H (2010) Alterations in portal vein blood pH, hepatic functions, and hepatic histology in a porcine carbon dioxide pneumoperitoneum model. Surg Endosc 24:1693\u20131700","journal-title":"Surg Endosc"},{"key":"8810_CR13","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1046\/j.1365-2168.2001.01700.x","volume":"88","author":"CN Gutt","year":"2001","unstructured":"Gutt CN, Riemer V, Kim ZG, Erceg J, Lorenz M (2001) Impact of laparoscopic surgery on experimental hepatic metastases. Br J Surg 88:371\u2013375","journal-title":"Br J Surg"},{"key":"8810_CR14","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1245\/s10434-007-9801-1","volume":"15","author":"DT Inderbitzin","year":"2008","unstructured":"Inderbitzin DT, Marti GR, Eichenberger S, Hoogewoud H, Kraehenbuehl L (2008) Enhanced tumour growth and impaired cellular antitumoural defense in hepatic colorectal carcinoma metastasis in rats after laparoscopy compared to open surgery. Ann Surg Oncol 15:1239\u20131248","journal-title":"Ann Surg Oncol"},{"key":"8810_CR15","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1007\/s00384-003-0486-z","volume":"18","author":"I Leister","year":"2003","unstructured":"Leister I, Manegold S, Sch\u00fcler P, Alves F, Becker H, F\u00fczesi L, Markus PM (2003) Effect of laparotomy and CO(2) pneumoperitoneum on tumor growth of human colon carcinoma and expression pattern of tumor-associated proteins in the SCID mouse. Int J Colorectal Dis 18:508\u2013513","journal-title":"Int J Colorectal Dis"},{"key":"8810_CR16","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1007\/s004640000331","volume":"15","author":"TC Schmandra","year":"2001","unstructured":"Schmandra TC, Kim ZG, Gutt CN (2001) Effect of insufflation gas and intraabdominal pressure on portal venous flow during pneumoperitoneum in the rat. Surg Endosc 15:405\u2013408","journal-title":"Surg Endosc"},{"key":"8810_CR17","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1007\/s00464-005-0061-5","volume":"19","author":"S Hasuki\u0107","year":"2005","unstructured":"Hasuki\u0107 S (2005) Postoperative changes in liver function tests: randomized comparison of low- and high-pressure laparoscopic cholecystectomy. Surg Endosc 19:1451\u20131455","journal-title":"Surg Endosc"},{"key":"8810_CR18","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1007\/s004649900612","volume":"12","author":"J Jakimowicz","year":"1998","unstructured":"Jakimowicz J, Stulti\u00ebns G, Smulders F (1998) Laparoscopic insufflation of the abdomen reduces portal venous flow. Surg Endosc 12:129\u2013132","journal-title":"Surg Endosc"},{"key":"8810_CR19","doi-asserted-by":"publisher","first-page":"2021","DOI":"10.1016\/S0022-5347(01)66079-8","volume":"155","author":"JS Wolf","year":"1996","unstructured":"Wolf JS, Clayman RV, McDougall EM, Shepherd DL, Folger WH, Monk TG (1996) Carbon dioxide and helium insufflation during laparoscopic radical nephrectomy in a patient with severe pulmonary disease. J Urol 155:2021","journal-title":"J Urol"},{"key":"8810_CR20","doi-asserted-by":"publisher","DOI":"10.1088\/1752-7155\/3\/4\/047005","author":"S Eaton","year":"2009","unstructured":"Eaton S, McHoney M, Giacomello L, Pacilli M, Bishay M, De Coppi P, Wood J, Cohen R, Pierro A (2009) Carbon dioxide absorption and elimination in breath during minimally invasive surgery. J Breath Res. https:\/\/doi.org\/10.1088\/1752-7155\/3\/4\/047005","journal-title":"J Breath Res"},{"key":"8810_CR21","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1006\/jsre.1995.1198","volume":"59","author":"HS Ho","year":"1995","unstructured":"Ho HS, Saunders CJ, Gunther RA, Wolfe BM (1995) Effector of hemodynamics during laparoscopy: CO2 absorption or intra-abdominal pressure? J Surg Res 59:497\u2013503","journal-title":"J Surg Res"},{"key":"8810_CR22","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1007\/s00464-007-9409-3","volume":"22","author":"M Bergstr\u00f6m","year":"2008","unstructured":"Bergstr\u00f6m M, Falk P, Park PO, Holmdahl L (2008) Peritoneal and systemic pH during pneumoperitoneum with CO2 and helium in a pig model. Surg Endosc 22:359\u2013364","journal-title":"Surg Endosc"},{"key":"8810_CR23","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1111\/j.1549-8719.2001.tb00178.x","volume":"8","author":"B Rippe","year":"2001","unstructured":"Rippe B, Rosengren BI, Venturoli D (2001) The peritoneal microcirculation in peritoneal dialysis. Microcirculation 8:303\u2013320","journal-title":"Microcirculation"},{"key":"8810_CR24","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1001\/archsurg.1997.01430270058012","volume":"132","author":"T Junghans","year":"1997","unstructured":"Junghans T, B\u00f6hm B, Gr\u00fcndel K, Schwenk W (1997) Effects of pneumoperitoneum with carbon dioxide, argon, or helium on hemodynamic and respiratory function. Arch Surg 132:272\u2013278","journal-title":"Arch Surg"},{"key":"8810_CR25","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1016\/j.gassur.2005.09.007","volume":"9","author":"EJ Hanly","year":"2005","unstructured":"Hanly EJ, Aurora AR, Fuentes JM, Shih SP, Marohn MR, De Maio A, Talamini MA (2005) Abdominal insufflation with CO2 causes peritoneal acidosis independent of systemic pH. J Gastrointest Surg 9:1245\u20131251 (discussion 1251\u20131242)","journal-title":"J Gastrointest Surg"},{"key":"8810_CR26","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1007\/BF02055434","volume":"40","author":"WS Chen","year":"1997","unstructured":"Chen WS, Lin W, Kou YR, Kuo HS, Hsu H, Yang WK (1997) Possible effect of pneumoperitoneum on the spreading of colon cancer tumor cells. Dis Colon Rectum 40:791\u2013797","journal-title":"Dis Colon Rectum"},{"key":"8810_CR27","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.1007\/s00464-004-2177-4","volume":"19","author":"K Izumi","year":"2005","unstructured":"Izumi K, Ishikawa K, Tojigamori M, Matsui Y, Shiraishi N, Kitano S (2005) Liver metastasis and ICAM-1 mRNA expression in the liver after carbon dioxide pneumoperitoneum in a murine model. Surg Endosc 19:1049\u20131054","journal-title":"Surg Endosc"},{"key":"8810_CR28","doi-asserted-by":"publisher","first-page":"1408","DOI":"10.1001\/archsurg.137.12.1408","volume":"137","author":"CN Gutt","year":"2002","unstructured":"Gutt CN, Kim ZG, Schemmer P, Kr\u00e4henb\u00fchl L, Schmedt CG (2002) Impact of laparoscopic and conventional surgery on Kupffer cells, tumor-associated CD44 expression, and intrahepatic tumor spread. Arch Surg 137:1408\u20131412","journal-title":"Arch Surg"},{"key":"8810_CR29","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1067\/msy.2000.105029","volume":"127","author":"CN Gutt","year":"2000","unstructured":"Gutt CN, Kim ZG, Schmandra T, Paolucci V, Lorenz M (2000) Carbon dioxide pneumoperitoneum is associated with increased liver metastases in a rat model. Surgery 127:566\u2013570","journal-title":"Surgery"},{"key":"8810_CR30","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1007\/s004649900332","volume":"11","author":"RY Fleming","year":"1997","unstructured":"Fleming RY, Dougherty TB, Feig BW (1997) The safety of helium for abdominal insufflation. Surg Endosc 11:230\u2013234","journal-title":"Surg Endosc"},{"key":"8810_CR31","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1007\/s00464-002-9015-3","volume":"17","author":"P Wildbrett","year":"2003","unstructured":"Wildbrett P, Oh A, Naundorf D, Volk T, Jacobi CA (2003) Impact of laparoscopic gases on peritoneal microenvironment and essential parameters of cell function. Surg Endosc 17:78\u201382","journal-title":"Surg Endosc"},{"key":"8810_CR32","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1007\/s00464-001-9166-7","volume":"16","author":"J Neudecker","year":"2002","unstructured":"Neudecker J, Sauerland S, Neugebauer E, Bergamaschi R, Bonjer HJ, Cuschieri A, Fuchs KH, Jacobi C, Jansen FW, Koivusalo AM, Lacy A, McMahon MJ, Millat B, Schwenk W (2002) The European Association for Endoscopic Surgery clinical practice guideline on the pneumoperitoneum for laparoscopic surgery. Surg Endosc 16:1121\u20131143","journal-title":"Surg Endosc"},{"key":"8810_CR33","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1007\/s004640000343","volume":"15","author":"G Galizia","year":"2001","unstructured":"Galizia G, Prizio G, Lieto E, Castellano P, Pelosio L, Imperatore V, Ferrara A, Pignatelli C (2001) Hemodynamic and pulmonary changes during open, carbon dioxide pneumoperitoneum and abdominal wall-lifting cholecystectomy. A prospective, randomized study. Surg Endosc 15:477\u2013483","journal-title":"Surg Endosc"}],"container-title":["Surgical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-021-08810-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-021-08810-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-021-08810-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T13:09:07Z","timestamp":1654088947000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00464-021-08810-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,5]]},"references-count":33,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["8810"],"URL":"https:\/\/doi.org\/10.1007\/s00464-021-08810-6","relation":{},"ISSN":["0930-2794","1432-2218"],"issn-type":[{"type":"print","value":"0930-2794"},{"type":"electronic","value":"1432-2218"}],"subject":[],"published":{"date-parts":[[2021,11,5]]},"assertion":[{"value":"3 April 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 October 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 November 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Tobias Ulrich Mueller, Grischa Marti, Simone Eichenberger, Beno\u00eet Fellay and Jean-Luc Magnin have no conflicts of interest or financial ties to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}