Does carbon dioxide pneumoperitoneum altering pressure levels lead to ultrastructural damage of fallopian tube and ovary?

AIM: To assess carbon dioxide pneumoperitoneum and its different pressure levels related to cellular injury on ovarian surface epithelium, endothelium, and fallopian tube ciliated epithelium in laparoscopic rat model.

MATERIALS AND

METHODS

Twenty-four Wistar-Albino female rats were randomized into three groups. Laparotomy was applied for Group 1 (control). Groups 2 and 3 had laparoscopy with pneumoperitoneum pressures at 10 mmHg and 15 mmHg, respectively. After 150 minutes (last 30 minutes was after desufflation for Group 2 and 3) in all groups, bilateral ovariectomy and salpingectomy were performed. The ultrastructures of ovarian surface epithelium, ovarian endothelium, and fallopian tube ciliated epithelium were evaluated by transmission electron microscope. Ovarian surface epithelium changes were divided into three groups, apical surface changes, lateral surface chances, and organelle modification/damage.

RESULTS

No apical or lateral surface changes or organelle modifications in ovarian surface epithelium were observed in the control group. Apical ovarian surface epithelium changes were statistically significant in Groups 2 and 3 in comparison to the control group. No significant differences were observed with regards to lateral surface changes in all groups. The organelle modification was only significant in Group 3 compared to the control group. The authors revealed that the ultrastructures of the ovarian endothelium and fallopian tube epithelium were not affected by pneumoperitoneum.

CONCLUSIONS

Pneumoperitoneum may cause ischemia-reperfusion damage in ovarian cortex correlated with the amount of pressure.