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Gas improves blood flow and organ status during minimally invasive surgery
Date:12/14/2009

DURHAM, N.C. As good as laparoscopy is in preventing some of the stresses of open surgery on the body, it does have drawbacks, including reduced blood flow and organ dysfunction. Laparoscopy is a type of surgery in the abdomen done through small incisions.

By adding another gas to the carbon dioxide used to inflate the surgical area during laparoscopy, researchers at Duke University Medical Center have found they can preserve more normal blood flow during noninvasive surgery.

The gas ethyl nitrite (ENO) helped to open blood vessels and keep blood flowing, which kept organs functioning normally during laparoscopy on pigs. The researchers did not complete any medical procedures on the pigs, which are similar in size and anatomy to humans. They merely created a laparoscopy situation by inflating the belly with carbon dioxide gas mixed with ENO. They then measured changes in heart rate, arterial pressure, cardiac output, organ blood flow, and certain chemical parameters like creatinine, a measure of kidney function, and cortisol, a stress-related hormone.

"We didn't see any downside to using ethyl nitrite during this study of minimally invasive surgery," said senior author James D. Reynolds, Ph.D., an associate professor of anesthesiology and member of the Duke Endosurgery Center. The study was published in the December issue of the journal CTS: Clinical and Translational Science.

"ENO has previously been administered to humans with no observed adverse effects, so it should be relatively easy to move this idea into a surgical clinical trial," Reynolds said.

By preserving blood flow and organ status, the use of ENO could improve outcomes and reduce the time of in-hospital recovery, he said. "It is promising news for surgical patients."

During the study, the research team determined that CO2 inflation produces "acute reductions in nitric oxide (NO) bioactivity," Reynolds said. Nitric oxide is now be
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Contact: Mary Jane Gore
mary.gore@duke.edu
919-660-1309
Duke University Medical Center
Source:Eurekalert

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