Objective: To evaluate pneumoperitoneal volumes (laparoscopic working space) in guinea pigs (Cavia porcellus) undergoing pneumoperitoneum via carbon dioxide insufflation at different intra-abdominal pressures (IAPs) (4, 6, and 8 mm Hg) and recumbencies (dorsal, right lateral, and left lateral).
Animals: Six 3- to 4-month-old sexually intact female Hartley guinea pigs.
Procedures: Guinea pigs were anesthetized, intubated, and had an abdominal insufflation catheter placed. A baseline abdominal CT scan was performed. Guinea pigs underwent insufflation, with each IAP given in a random order for 10 to 15 minutes with a washout period of 5 minutes between pressures. Abdominal CT scans were acquired at each IAP and at each recumbency. Pneumoperitoneal volumes were calculated using software.
Results: Increases in IAP increased working space significantly (P < .001). The 6- and 8-mm Hg pressures increased working space from 4 mm Hg by 7.3% and 19.8%, respectively. Recumbent positioning (P = .60) and body weight (P = .73) did not affect working space. Order of IAP had a significant (P = .006) effect on working space. One of the guinea pigs experienced oxygen desaturation and bradycardia at 6- and 8-mm Hg IAP.
Clinical Relevance: Although an increased working space occurred at 6 and 8 mm Hg compared to 4 mm Hg, further research is needed concerning the cardiovascular effects of pneumoperitoneum in guinea pigs to determine whether those higher IAPs are safe in this species. An IAP of 6 mm Hg can be considered for laparoscopic cannula placement, followed by a lower IAP for laparoscopic procedures.
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http://dx.doi.org/10.2460/ajvr.22.03.0031 | DOI Listing |
Proc Natl Acad Sci U S A
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Department of Chemistry, Chemical Theory Center, University of Minnesota, Minneapolis, MN 55455-0431.
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Department of Physics, JC STEM Lab of Energy and Materials Physics, City University of Hong Kong, Hong Kong 999077, P. R. China.
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Jožef Stefan Institute, Jamova cesta 39, SI-1000 Ljubljana, Slovenia.
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Department of Molecular and Comparative Pathobiology, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA.
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Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
The global increase in urolithiasis prevalence has led to a shift towards minimally invasive procedures, such as retrograde intrarenal surgery, supported by advancements in laser technologies for lithotripsy. Pulsed lasers, particularly the holmium YAG and the newer thulium fiber laser, have significantly transformed the management of upper urinary tract stones. However, the use of high-power lasers in these procedures introduces risks of heat-related injury.
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