Effect of adding more than 3% oxygen to carbon dioxide pneumoperitoneum on adhesion formation in a laparoscopic mouse model

Objective: To investigate the effect of the addition of 3% or higher oxygen concentrations to the carbon dioxide (CO2) pneumnoperitoneum. Design: Prospective, randomized trial. Setting: Academic research center. Animal(s): Female Naval Medical Research Institute mice (n = 100). Intervention(s): Sixty minutes of CO2 pneurnoperitoneum with 0%, 3%, 6%, 9%, or 12% oxygen; induction of adhesions by the creation of standardized peritoneal lesions during laparoscopy. Main Outcome Measure(s): Adhesions were quantitatively and qualitatively scored after 7 days during laparotomy to determine [1] the effect of 60 minutes of CO2 pneumoperitoneum with 0%, 3%, 6%, 9%, or 12% oxygen on adhesion formation, and [2] the effect of duration of CO2 pneumoperitoneum and insufflation pressure on adhesion formation with the addition of 0%, 3%, and 12% oxygen. Result(s): Compared with a CO2 pneumoperitoneum with 3% oxygen, adhesion formation is greater when either no oxygen or more than 3% oxygen is added to the CO2 pneumoperitoneum. These effects persisted at higher insufflation pressures and longer duration of pneumoperitoneum, both known to increase adhesion formation with pure CO2. Conclusion(s): This study confirms that adhesion formation is decreased with the addition of 3% oxygen to the CO2 pneumoperitoneum. The addition of higher oxygen concentrations, however, is deleterious. Adhesions always increase with time and duration of the pneurnoperitoneum. (C) 2004 by American Society for Reproductive Medicine.