Laparoscopic abdominal wall components separation in a porcine model of intra-abdominai hypertension / 中华普通外科杂志

ABSTRACT

Objective To determine the effect of laparoscopic abdominal wall components separation procedure on a porcine model of intra-abdominal hypertension (IAH). Methods IAH to 25 nun Hg was created by insufllating carbon dioxide into abdominal cavity of eight anesthetized pigs. Bilateral subcutaneous tunnels above the plane of the abdominal musculature were developed. Dissection of the external oblique insertion and development of the plane between external and internal oblique muscles was performed using ultrasonic scalpel monitored by laparoscopy. Changes in intra-abdominal pressure (IAP), waistline (WL), mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP) were recorded. Results Following intra-abdominal hypertension, WL, MAP, HR and CVP changed significantly. After laparoscopic abdominal wall components separation, there was a significant decrease in IAP from 25 mm Hg to ( 16. 0 ± 1.5 ) mm Hg ( P < 0. 01 ). Also, this procedure increased WL by (5.6 ± 2. 0) cm [ from (65.3 ± 2. 5 ) cm to (88 ± 14) cm; P < 0. 01 ]. Due to abdominal depression, the MAP was significantly increased from to (88 ± 14) mm Hg to ( 100 ± 12) mm Hg ( P <0. 01 ). Moreover, there were significant improvements in circulation status including HR from (115 ± 9) beat per minute (bpm) to (97 ± 7) bpm (P<0.01), CVP from (10.8±2.2) cm H2O to (7.3 ± 1.8) cm H2O (P<0.01), etc. Conclusions IAH results in changes of hemedynnmies. Laparoscopic abdominal wall components separation significantly decreases IAH improving porcine hemodynamics.