The effects of carbon dioxide pneumoperitoneum on ovarian blood flow, oxidative stress markers, and morphology during laparoscopy: a rabbit model

Objective: To determine the effect of CO2 pneumoperitoneum on the ovaries in in experimental pneumoperitoneum model. Design: Experimental Controlled Study. Setting: University hospital. Patient(s): Sixteen adult Female conventional rabbits. Intervention(s): Group I (8 rabbits) was not subjected to intra-abdominal pressure (IAP). In group 11 (8 rabbits), IAP insufflation was performed at 12 turn Hg. In total, 60 minutes of pneumoperitoneum and 10 minutes of reperfusion were maintained. Ovarian blood flow (OBF) was studied using laser Doppler flowmetry. The time points of OBF measurements were is follows: OBFbaseline, 10 minutes before insufflation OBF30min, 30 minutes after pneumoperitoneum OBF60min, 60 minutes after pneumoperitoneum; and OBFreperfusion, 10 minutes after pneumoperitoneum desufflation. Mean OBF changes during CO2 pneumoperitoneum (OBFmean) were also assessed. Main Outcome Measure(s): Blood perfusion units, tissue malondialdehyde values, and histopathologic damage scones, Result(s): In group 11, mean OBF Values were significantly lower than in group 1, especially for OBF30min, OBF60min, OBFreperfusion, and OBFmean. The mean tissue malondialdehyde value for group 11 was significantly higher than in the control group (104.48 +/- 20.07 nmol/g vs. 64.12 +/- 8.77 nmol/g, respectively). Compared with group 1, in group 11 histologic specimens of the ovaries had higher scores for follicular cell degeneration, vascular congestion, hemorrhage, and inflammatory cell infiltration. Conclusion(s): Pneumoperitoneum, even at normal IAP levels, leads to significant oxidative stress-induced biochemical and histologic damage to the ovaries. (Fertil Steril (R) 220 10:93:1327-32. (C) 2010 by American Society for Reproductive Medicine.)