Ott Douglas E
Biomedical Engineering Department, School of Engineering, Mercer University, Macon, Georgia, USA.
JSLS. 2003 Jul-Sep;7(3):189-95.
To assess the effects of gas flow during insufflation on peritoneal fluid and peritoneal tissue regarding transient thermal behavior and thin-film evaporation. The effects of laparoscopic gas on peritoneal cell desiccation and peritoneal fluid thin-film evaporation were analyzed.
Measurment of tissue and peritoneal fluid and analysis of gas flow dynamics during laparoscopy.
High-velocity gas interface conditions during laparoscopic gas insufflation result in peritoneal surface temperature and decreases up to 20 degrees C/second due to rapid thin-film evaporation of the peritoneal fluid. Evaporation of the thin film of peritoneal fluid extends quickly to the peritoneal cell membrane, causing peritoneal cell desiccation, internal cytoplasmic stress, and disruption of the cell membrane, resulting in loss of peritoneal surface continuity and integrity. Changing the gas conditions to 35 degrees C and 95% humidity maintains normal peritoneal fluid thin-film characteristics, cellular integrity, and prevents evaporative losses.
Cold, dry gas and the characteristics of the laparoscopic gas delivery apparatus cause local peritoneal damaging alterations by high-velocity gas flow with extremely dry gas, creating extreme arid surface conditions, rapid evaporative and hydrological changes, tissue desiccation, and peritoneal fluid alterations that contribute to the process of desertification and thin-film evaporation. Peritoneal desertification is preventable by preconditioning the gas to 35 degrees C and 95% humidity.
评估气腹过程中气流对腹膜液和腹膜组织瞬态热行为及薄膜蒸发的影响。分析腹腔镜气体对腹膜细胞干燥和腹膜液薄膜蒸发的影响。
在腹腔镜检查期间测量组织和腹膜液并分析气流动力学。
腹腔镜气腹过程中的高速气体界面条件会导致腹膜表面温度因腹膜液的快速薄膜蒸发而每秒下降多达20摄氏度。腹膜液薄膜的蒸发迅速扩展到腹膜细胞膜，导致腹膜细胞干燥、内部细胞质应激和细胞膜破坏，从而导致腹膜表面连续性和完整性丧失。将气体条件改变为35摄氏度和95%湿度可维持正常的腹膜液薄膜特性、细胞完整性，并防止蒸发损失。
寒冷、干燥的气体以及腹腔镜气体输送装置的特性通过高速气流和极干燥的气体导致局部腹膜损伤性改变，产生极端干旱的表面条件、快速的蒸发和水文变化、组织干燥以及腹膜液改变，这些都促成了沙漠化和薄膜蒸发过程。通过将气体预处理至35摄氏度和95%湿度可预防腹膜沙漠化。
