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10.5005/jp-journals-10033-1182
Effect of Different Carbon Dioxide Pressure Gradients in Capnoperitoneum for Laparoscopic Examination in Dogs
RESEARCH ARTICLE
Effect of Different Carbon Dioxide Pressure Gradients in

Capnoperitoneum for Laparoscopic Examination in Dogs

Swapan Kumar Maiti, Avijit Dutta, Jagadish Varshney, Naveen Kumar

ABSTRACT electrocardiogram is therefore a very useful mean for
continuous assessment of patient’s condition during
Eighteen female mongrel bitches, equally divided into three
groups (A, B and C) were subjected to CO insufflation at 6, 10 laparoscopy. In addition, blood gas analysis has been proved
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and 14 mm Hg pressure gradient respectively to study the very useful to evaluate the effect of CP. Increased intra-
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physiological changes of capnoperitoneum during laparoscopy. abdominal pressure affects various intra-abdominal organs
Optimum visualization of internal organs during laparoscopy was
achieved at 10 and 14 mm Hg of CO pressure gradient. The and is linearly regulated by its level and durations. Alteration
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physiological effects were more pronounced at 14 mm Hg of of hepatic function has been reported following laparoscope
CO pressure gradient. Marked increase of respiration rate in surgery. 1
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correlation with increased pCO and decreased pO was
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observed in the group C. Bradyarrhythmia was observed in all So far, very little works has been carried out on CP
three groups, however, myocardial ischemia or hypoxia as pressure gradient to establish a most suitable one for canine
reflected through S-T segment depression and elevation was species with having minimum adverse effects. Therefore,
more pronounced in 14 mm Hg of CO pressure gradient
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(group C). Alteration of liver function was within the physiological the present study was undertaken to evaluate the
range in the animals of all the three groups. Physiological stress physiological effect of CP using different CO pressure
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was remained significantly higher with 14 mm Hg intra-abdominal gradients and to find a most suitable one for routine
pressure. In conclusion, 10 mm Hg of CO was found most laparoscopic examination and surgery in canines.
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suitable pressure gradient for laparoscopic examination in dogs.
Keywords: Capnoperitoneum, Dog, Intra-abdominal pressure, MATERIALS AND METHODS
Electrocardiography, Laparoscopic surgery.
The study was conducted on 18 clinically healthy adult
How to cite this article: Maiti SK, Dutta A, Varshney J,
Kumar N. Effect of Different Carbon Dioxide Pressure Gradients female mongrel dogs with body weights of 15 to 20 kg and
in Capnoperitoneum for Laparoscopic Examination in Dogs. aged 16 to 22 months. The animals were randomly divided
World J Laparosc Surg 2013;6(2):53-62. into three equal groups (A, B and C) consisting of six
Source of support: Nil animals each. Different CO pressure gradients were used
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Conflict of interest: None declared to produce CP for laparoscopic visualization of different
intra-abdominal organs in these three groups of animals.
INTRODUCTION In group A, CO pressure gradient was 6 mm Hg, whereas,
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in groups B and C it was 10 and 14 mm Hg respectively.
Laparoscopy is now considered as one of the most potent
and promising aids for both its diagnostic and therapeutic After administration of general anesthesia, the animals were
use. It involves minimal invasiveness (keyhole surgery) with placed in dorsal recumbency and then in the Trendelenburg
maximum visibility, shorter surgical time, decreased position for laparoscopic visualization of different
postoperative discomfort and pain, less incidence of intraperitoneal organs.
infection, uncomplicated healing with minimal scarring, and A small 0.5 cm skin incision was made at the level of
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minimal surgical morbidity. Laparoscopy is now emerging the umbilicus and a Verees needle was inserted. Insufflation
as a diagnostic and therapeutic tool in the medical field. 3 of the abdominal cavity was achieved with carbon dioxide
Laparoscopic examination requires the separation of gas at the rate of 2 L/min with a pressure gradient of 6,
structures from the abdominal wall. Insufflations of the 10 and 14 mm Hg in groups A, B and C respectively.
abdomen with most suitable gas CO optimally separates A 6 mm safety trocar and cannula unit was inserted into the
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the intra-abdominal organs from ventral and lateral walls. 4 abdominal cavity. A rigid-type telescope connected to a light
In response to CO capnoperitoneum (CP) there are series source and a digital camera was then introduced through
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of physiologic responses that have an impact on cardio- the cannula. The intra-abdominal organs were visualized
pulmonary function of animal. These responses include the thoroughly. After completing the laparoscopic examination,
hemodynamic changes related to mechanical and CO gas was allowed to escape through the cannula. The
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neuroendocrine effects of CP and effects of absorbed CO 2 incisions were sutured with simple interrupted sutures.
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on cardiovascular and respiratory function. Routine Antiseptic dressing was applied regularly for 3 days post-
World Journal of Laparoscopic Surgery, May-August 2013;6(2):53-62 53