Chronic effect of pneumoperitoneum on renal histology

Benjamin R. Lee, Jeffrey A. Cadeddu, Gyongyi Molnar-Nadasdy, Debbie Enriquez, Tibor Nadasdy, Louis R. Kavoussi, Lloyd E. Ratner

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Background and Objective: Transient intraoperative oliguria is a constant phenomenon during laparoscopic procedures. Laboratory studies have demonstrated that this effect is secondary to a decrease in renal blood flow caused by the pneumoperitoneum. With the advent of laparoscopic harvest of the kidney for renal transplantation, a concern is that increased intra- abdominal pressure may compound the effect of acute cold and warm renal ischemia during transplantation. Acute transient renal ischemia can produce chronic sclerosing histopathologic changes in native kidneys which are similar to those seen in chronic allograft rejection. The effect of positive- pressure abdominal pneumoperitoneum (15 mm Hg) on native kidneys was examined using a rodent model. The effects on renal function and histologic features were also studied. Materials and Methods: Twenty-four Harlan Wistar-Furth rats were divided into four groups: controls, 1-hour pneumoperitoneum-91-day survival, 5-hour pneumoperitoneum-91-day survival, and 5-hour pneumoperitoneum-7-day survival. Control animals underwent placement of the Veress needle and anesthesia but no induction of pneumoperitoneum. At the time of sacrifice, blood was sampled for serum creatinine measurement. Both kidneys were harvested for frozen and permanent section and stained using hematoxylin and eosin. Specimens were graded for inflammatory and ischemic/sclerotic changes in the interstitium, tubules, glomeruli, and vasculature by a renal pathologist using a histologic score (0-3). Results: In all groups, at a sacrifice interval of either 1 week or 3 months, there were no statistical differences in the histologic score, serum creatinine concentration, or renal weight. Conclusions: In a rodent model, no signs of chronic ischemic histologic changes were detected for a period of 3 months after up to 5 hours of pneumoperitoneum. As well, there was no change in the serum creatinine concentration.

Original languageEnglish (US)
Pages (from-to)279-282
Number of pages4
JournalJournal of Endourology
Issue number4
StatePublished - May 1999

ASJC Scopus subject areas

  • Urology


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