Prevention of adhesions with crystalloids during laparoscopic surgery in mice

Study Objective. To evaluate the effect of saline and Ringer's lactate solutions in preventing adhesions during laparoscopic surgery in mice. Design. Prospective, randomized trial (Canadian Task Force classification I). Setting. Academic research center. Subjects. Ninety-two female Naval Medical Research Institute mice. Intervention. Adhesions were induced laparoscopically by opposing bipolar lesions in the uterine horns and pelvic sidewalls, and saline or Ringer's lactate solution was added at different times during the procedure. Measurements and Main Results. Adhesions were scored quantitatively and qualitatively for extent, type, and tenacity after 7 days under microscopic vision during laparotomy, After 45 minutes of pneumoperitoneum, neither solution reduced adhesion formation, but when added immediately after surgery they did (p = 0.002). Coagulation was not significantly different with addition of either solution immediately after coagulation. In the third experiment the presence of fluid during pneumoperitoneum decreased adhesion formation (p = 0.0001) but Ringer's lactate was more effective than saline (p = 0.0005). Conclusion. Crystalloids. reduced CO2 pneumoperitoneum-enhanced adhesion formation in a laparoscopic mouse model, but Ringer's lactate solution was more effective than saline.