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Microdialysis monitoring for evaluation of the influence exertedby pneumoperitoneum on the kidney: an experimental study
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2008 (English)In: Surgical Endoscopy, ISSN 0930-2794, Vol. 22, 938-942 p.Article in journal (Refereed) Published
Abstract [en]


Laparoscopic donor nephrectomy has

become the first choice for living donor kidney transplantation,

offering advantages over open donor nephrectomy.

This study aimed to evaluate kidney tissue metabolism

during and after pneumoperitoneum using a microdialysis



Eight pigs underwent laparotomy and implantation

of two microdialysis catheters: one in the cortex and

one in the medulla of the left kidney. After laparotomy, the

abdominal wall was closed, and pneumoperitoneum was

induced with a constant standard pressure of 16 to 18

mmHg for 4 h, followed by rapid desufflation. In microdialysis

samples collected from intrarenal catheters,

markers of ischemia (glucose, lactate, pyruvate, and lactate–

pyruvate ratio) and the marker of cell membrane

injury (glycerol) were monitored.


There were no changes in glucose, lactate, or

pyruvate level before, during, or after pneumoperitoneum,

either in the cortex or in the medulla. Additionally, the

calculated lactate–pyruvate ratio did not show signs of

ischemia during or after pneumoperitoneum. However,

with regard to the marker of cell injury, glycerol increased

in the medulla after decompression from 22.57 ± 3.76 to

35.67 ± 5.43 mmol/l (

p < 0.01). This release of glycerol in

the medulla was significantly higher than in the cortex

(area under the curve [AUC], 22.18 ± 4.87 vs

34.79 ± 7.88 mmol/l;

p < 0.01).


The pattern of metabolic changes monitored

in the kidney during and after pneumoperitoneum indicates

some kind of cell injury predominant in the medulla without

any signs of kidney ischemia. This nonischemic injury could

be related to hyperperfusion of the kidney after decompression

or injury to cells attributable to mechanical cell

expansion at the point of rapid decompression.

Place, publisher, year, edition, pages
2008. Vol. 22, 938-942 p.
Keyword [en]
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-244844DOI: 10.1007/s00464-007-9525-0OAI: oai:DiVA.org:uu-244844DiVA: diva2:789986
Available from: 2015-02-22 Created: 2015-02-22 Last updated: 2015-02-22

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Yamamoto, Shinji
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