Laparoscopic techniques are being used with increasing frequency for a wide number of diagnostic and surgical procedures in veterinary medicine.1-5 In human medicine, laparoscopy is considered the standard technique for many surgical procedures.6-8 However, a major concern associated with laparoscopy for neoplastic disease in humans is port site metastasis,9-12 which is defined as early recurrent tumorous lesions that develop locally in the abdominal wall within the scar tissue of 1 or more trocar sites that are not associated with diffuse peritoneal carcinoma- tosis.13 Port site metastasis has only been reported in veterinary medicine after thoracoscopic surgery in a dog.5 Factors influencing port site metastasis are unknown9,12; however, direct contamination,14 aerosolization,15 the chimney effect,16 the local immune response,17 and establishment of pneumoperitoneum18 have been suggested as possible causes.
Studies11,19 in laboratory animals have revealed that CO2 insufflation increases the risk of tumor implantation. Other investigations into the effects of CO2-induced pneumoperitoneum revealed an association with intraperitoneal acidosis in rats,20,21 mice,22 and swine.23 Several investigators have proposed21,22 that alterations of the peritoneal surface as a result of intraperitoneal acidosis associated with CO2 insufflation may facilitate port site metastasis.
Laparoscopy is becoming a commonly used method for diagnostic and surgical procedures in dogs. Abdominal neoplasms in dogs are often biopsied by use of laparoscopy, but the risk for development of port site metastasis in these dogs is unknown. To our knowledge, alteration of intraperitoneal pH has not been investigated in dogs. The objective of the study reported here was to investigate the effect of CO2 insufflation on pH of intraperitoneal fluid in dogs. We hypothesized that CO2 insufflation during laparoscopy would not induce peritoneal fluid acidosis in dogs.
Vedco Inc, St Joseph, Mo.
Baxter Healthcare Corp, Deerfield, Ill.
VetaKet, Phoenix Scientific Inc, St Joseph, Mo.
Hospira Inc, Lake Forest, Ill.
Abbott Laboratories, North Chicago, Ill.
Hospira Inc, Lake Forest, Ill.
pH-indicator type CS, Whatman International Ltd, Maidstone, England.
Auto Suture, United States Surgical Corp, Norwalk, Conn.
Storz Endoflator 26012, Karl Storz Endovision, Charlton, Mass.
IRMA Trupoint blood gas analysis system, ITC, Edison, NJ.
Parenta Pharmaceuticals Inc, West Columbia, SC.
Bedford Laboratories, Bedford, Ohio.
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