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Hum. Reprod. Advance Access published online on August 27, 2004
Human Reproduction, doi:10.1093/humrep/deh495
© 2004 by European Society of Human Reproduction and Embryology
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Received May 13, 2004
Accepted August 2, 2004

Article

Effect of temperature upon adhesion formation in a laparoscopic mouse model

M.M. Binda 1*, C.R. Molinas 1, K. Mailova 1, P.R. Koninckx 1

1 Department of Obstetrics and Gynaecology, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Herestraat 49, B3000 Leuven, Belgium

* To whom correspondence should be addressed. E-mail: MariaMercedes.Binda{at}uz.kuleuven.ac.be.


  Abstract

BACKGROUND: Pneumoperitoneum can be a cofactor in adhesion formation. Pneumoperitoneum with non-humidified gas causes desiccation in the peritoneal cavity which decreases temperature. The effect of desiccation upon adhesion formation is widely accepted. The specific effect of the associated cooling upon adhesion formation remains unexplored, and was addressed specifically in our laparoscopic mouse model. METHODS: Adhesions were induced during laparoscopy and scored after 7 days during laparotomy. Pneumoperitoneum was performed using CO2 or CO2 with oxygen with or without humidification. Animals were placed at different environmental temperatures to modulate body and intraperitoneal temperature. RESULTS: Anaesthesia, environment with a lower temperature and pneumoperitoneum all independently decrease body temperature. A decrease in body temperature decreases adhesion formation (P=0.004). Therefore, at 37°C, pneumoperitoneum-enhanced adhesion formation is more important than at room temperature (P=0.04). As was observed at room temperature, adhesion formation at 37°C increases with the duration (P=0.01) of pneumoperitoneum and decreases with the addition of 3% of oxygen (P=0.03). CONCLUSIONS: Hypothermia reduces pneumoperitoneum-enhanced adhesion formation, which supports hypoxia as a driving mechanism, since hypothermia decreases the toxic effects of hypoxia and of the ischaemia-reperfusion process. These data could open up new possibilities for adhesion prevention in laparoscopic surgery.

Keywords: body temperature; desiccation; hypoxia; intraperitoneal adhesion formation; laparoscopy; pneumoperitoneum.
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