Laparoscopy and Tribology: The Effect of Laparoscopic Gas on Peritoneal Fluid

Abstract

Study Objective To assess the changes in viscosity of peritoneal fluid during laparoscopic exposure to CO 2 insufflation. Design Analysis and mathematic modeling of peritoneal fluid viscosity in vivo and in vitro as a result of exposure to unconditioned CO 2 (Canadian Task Force classification II-2). Setting Medical school university research laboratory and hospital. Materials Peritoneal fluid from 45 women. Intervention Peritoneal fluid was obtained at laparoscopy before insufflation and tested for viscosity after exposure to currently used raw dry unconditioned CO 2. Measurements and Main Results Peritoneal fluid viscosity was tested by viscometric methods and mathematic modeling. Initial viscosity of peritoneal fluid before gas exposure was 1.425 centipoise (cP). Viscosity measurements were obtained at 20-second intervals for gas flows of 1 and 3 L/minute. Increases in viscosity occur rapidly, and by 200 seconds it was 59 cP and 98 cP for 1 and 3 L flow rates, respectively. Conclusion Very dry CO 2 for laparoscopy causes peritoneal fluid viscosity to increase dramatically.