SS  Vol.3 No.7 , July 2012
A Novel Rodent Model Modifying Perioperative Temperature and Humidity during Bowel Surgery and Mimicking Laparoscopic Conditions
Abstract: Laparoscopic surgery seems to have a general physiological benefit compared to conventional procedures in several clincal studies especially regarding intestinal anastomotic healing. Reliable experimental data concerning the particular mode of beneficial action are lacking. Clinical studies will not be able to identify the variables responsible for this effect. To establish a feasible, standardized experimental model to investigate variables such as humidity and perioperative room temperature, we employed an incubator designed for neonatal care. This allows individual manipulation and observation of above mentioned variables. Our initial results show that creating intestinal anastomoses in the incubator is safe and easy to perform, creating a valuable possibility to influence perioperative conditions for experimental and clinical research.
Cite this paper: T. Glatz, G. Seifert, P. Holzner, S. Chikhladze, B. Kulemann, O. Sick, J. Höppner, U. Hopt and G. Marjanovic, "A Novel Rodent Model Modifying Perioperative Temperature and Humidity during Bowel Surgery and Mimicking Laparoscopic Conditions," Surgical Science, Vol. 3 No. 7, 2012, pp. 353-357. doi: 10.4236/ss.2012.37069.

[1]   E. Cotte, F. Mohamed, S. Nancey, Y. Francois, O. Glehen, B. Flourié, et al., “Laparoscopic total colectomy: Does the indication influence the outcome?” The World Journal of Gastrointestinal Surgery, Vol. 3, No. 11, 2011, pp. 177-182.

[2]   K. El Zarrok Elgazwi, I. Baca, L. Grzybowski and A. Jacks, “Laparoscopic Sigmoidectomy for Diverticulitis: A Prospective Study,” Journal of the Society of Laparoendscopic Surgeons, Vol. 14, No. 4, 2010, pp. 469-475.

[3]   D. W. Good, J. M. O’Riordan, D. Moran, F. B. Keane, E. Eguare, D. S. O’Riordain, et al., “Laparoscopic Surgery for Rectal Cancer: A Single-Centre Experience of 120 Cases,” International Journal of Colorectal Disease, Vol. 26, No. 10, 2011, pp. 1309-1315. doi:10.1007/s00384-011-1261-1

[4]   J. Royds, J. O’Riordan, E. Eguare, D. O’Riordain and P. Neary, “Laparoscopic Surgery for Complicated Diverticular Disease: A Single Centre Experience,” Colorectal Disease, 2011. doi:10.1111/j.1463-1318.2011.02924.x

[5]   J. J. Luján, Z. H. Németh, P. A. Barratt-Stopper, R. Bustami, V. P. Koshenkov and R. H. Rolandelli, “Factors Influencing the Outcome of Intestinal Anastomosis,” The American Journal of Surgery, Vol. 77, No. 9, 2011, pp. 1169-1175.

[6]   J. W. T. Dekker, G. J. Liefers, J. C. A. de van Mol Otterloo, H. Putter and R. A. E. M. Tollenaar, “Predicting the Risk of Anastomotic Leakage in Left-Sided Colorectal Surgery Using a Colon Leakage Score,” Journal of Surgical Research, Vol. 166, No. 1, 2011, pp. e27-e34. doi:10.1016/j.jss.2010.11.004

[7]   C. H. Richards, V. Campbell, C. Ho, J. Hayes, T. Elliott and M. Thompson-Fawcett, “Smoking Is a Major Risk Factor for Anastomotic Leak in Patients Undergoing Low Anterior Resection,” Colorectal Disease, Vol. 14, No. 5, 2011, pp. 628-633. doi:10.1111/j.1463-1318.2011.02718.x

[8]   M. A. Boccola, P. G. Buettner, W. M. Rozen, S. K. Siu, A. R. L. Stevenson, R. Stitz, et al., “Risk Factors and outcomes for Anastomotic Leakage in Colorectal Surgery: A Single-Institution Analysis of 1576 Patients,” World J Surg, Vol. 35, No. 1, 2011, pp. 186-195. doi:10.1007/s00268-010-0831-7

[9]   M. A. Boccola, J. Lin, W. M. Rozen and Y. Ho, “Reducing Anastomotic Leakage in Oncologic Colorectal Surgery: An Evidence-Based Review,” Anticancer Research, Vol. 30, No. 2, 2010, pp. 601-607.

[10]   D. H. Choi, J. K. Hwang, Y. T. Ko, H. J. Jang, H. K. Shin, Y. C. Lee, et al., “Risk Factors for Anastomotic Leakage after Laparoscopic Rectal Resection,” Journal of the Korean Society of Coloproctology, Vol. 26, No. 4, 2010, pp. 265-273.

[11]   R. Rosch, M. Stumpf, K. Junge, D. Ardic, F. Ulmer and V. Schumpelick, “Impact of Pressure and Gas Type on Anastomotic Wound Healing in Rats,” Langenbecks Archives of Surgery, Vol. 389, No. 4, 2004, pp. 261-266. doi:10.1007/s00423-004-0491-x

[12]   M. Ulas, I. Ozer, M. Ercan, Y. B. Ozogul, E. B. Bostanci, T. T. Keklik, et al., “Effects of CO2 Pneumoperitoneum on Anastomotic Healing in Rats Receiving Preoperative 5-Fluorouracil Neoadjuvant Chemotherapy,” Journal of Investigative Surgery, Vol. 22, No. 6, 2009, pp. 413-418. doi:10.3109/08941930903410841

[13]   S. H. A. J. Tytgat, G. T. Rijkers and D. C. van der Zee, “The Influence of the CO2 Pneumoperitoneum on a Rat Model of Intestinal Anastomosis Healing,” Surgical Endoscopy, Vol. 26, No. 6, 2011, pp. 1642-1647. doi:10.1007/s00464-011-2086-2

[14]   A. M. Kappas, K. Papadimitriou, M. Fatouros and D. Cassioumis, “Influence of Local Hyperthermia on the Healing of Small Intestinal Anastomoses in the Rat,” British Journal of Surgery, Vol. 78, No. 7, 1991, p. 890. doi:10.1002/bjs.1800780742

[15]   T. Shimizu, M. Maeta and S. Koga, “Influence of Local Hyperthermia on the Healing of Small Intestinal Anastomoses in the Rat,” British Journal of Surgery, Vol. 78, No. 1, 1991, pp. 57-59. doi:10.1002/bjs.1800780119

[16]   R. Corona, J. Verguts, R. Koninckx, K. Mailova, M. M. Binda and P. R. Koninckx, “Intraperitoneal Temperature and Desiccation during Endoscopic Surgery. Intraoperative Humidification and Cooling of the Peritoneal Cavity Can Reduce Adhesions,” American Journal of Obstetrics & Gynecology, Vol. 205, No. 4, 2011, pp. 392.e1-392.e7.

[17]   D. W. Birch, N. Manouchehri, X. Shi, G. Hadi and S. Karmali, “Heated CO2 with or without Humidification for Minimally Invasive Abdominal Surgery,” Cochrane Database of Systematic Reviews, 2011, p. CD007821.

[18]   J. Hoeppner, V. Crnogorac, G. Marjanovic, E. Jüttner, W. Karcz, H. Weiser, et al., “Small Intestinal Submucosa as a Bioscaffold for Tissue Regeneration in Defects of the Colonic Wall,” Journal of Gastrointestinal Surgery, Vol. 13, No. 1, 2009, pp. 113-119. doi:10.1007/s11605-008-0639-z

[19]   J. Hoeppner, G. Marjanovic, P. Helwig, U. T. Hopt and T. Keck, “Extracellular Matrices for Gastrointestinal Surgery: Ex Vivo Testing and Current Applications,” World Journal of Gastroenterology, Vol. 16, No. 32, 2010, pp. 4031-4038. doi:10.3748/wjg.v16.i32.4031

[20]   J. Hoeppner, B. Wassmuth, G. Marjanovic, S. Timme, U. T. Hopt and T. Keck, “Anastomotic Sealing by Extracellular Matrices (ECM) Improves Healing of Colonic Anastomoses in the Critical Early Phase,” Journal of Gastrointestinal Surgery, Vol. 14, No. 6, 2010, pp. 977-986. doi:10.1007/s11605-010-1191-1

[21]   J. Hoeppner, K. Willa, S. Timme, D. Tittelbach-Helmrich, U. T. Hopt, T. Keck, et al., “Reinforcement of Colonic Anastomoses with a Collagenous Double-Layer Matrix Extracted from Porcine Dermis,” European Surgical Research, Vol. 45, No. 2, 2010, pp. 68-76. doi:10.1159/000318856

[22]   G. Marjanovic, C. Villain, E. Juettner, A. Zur Hausen, J. Hoeppner, U. T. Hopt, et al., “Impact of Different Crystalloid Volume Regimes on Intestinal Anastomotic Stability,” Annals of Surgery, Vol. 249, No. 2, 2009, pp. 181-185. doi:10.1097/SLA.0b013e31818b73dc

[23]   G. Marjanovic, C. Villain, S. Timme, A. Zur Hausen, J. Hoeppner, F. Makowiec, et al., “Colloid vs. Crystalloid Infusions in Gastrointestinal Surgery and Their Different Impact on the Healing of Intestinal Anastomoses,” International Journal of Colorectal Disease, Vol. 25, No. 4, 2010, pp. 491-498. doi:10.1007/s00384-009-0854-4

[24]   G. Marjanovic, E. Jüttner, A. Zur Hausen, U. Theodor Hopt and R. Obermaier, “Ischemic Preconditioning Improves Stability of Intestinal Anastomoses in Rats,” International Journal of Colorectal Disease, Vol. 54, No. 8, 2009, pp. 975-981.

[25]   A. F. A. Veenhof, M. S. Vlug, M. H. G. M. van der Pas, C. Sietses, D. L. van der Peet, E. S. M. de Lange-de Klerk, et al., “Surgical Stress Response and Postoperative Immune Function after Laparoscopy or Open Surgery with Fast Track or Standard Perioperative Care: A Randomized Trial,” Annals of Surgery, Vol. 255, No. 2, 2012, pp. 216-221. doi:10.1097/SLA.0b013e31824336e2

[26]   M. Levack, D. Berger, P. Sylla, D. Rattner and L. Bordeianou, “Laparoscopy Decreases Anastomotic Leak Rate in Sigmoid Colectomy for Diverticulitis,” Archives of Surgery, Vol. 146, No. 2, 2011, pp. 207-210. doi:10.1001/archsurg.2010.325

[27]   Azadani, H. Jonsson, P. Park and M. Bergstrom, “A Randomized Trial Comparing Rates of Abdominal Contamination and Postoperative Infection among Natural Orifice Transluminal Endoscopic Surgery, Laparoscopic Surgery, and Open Surgery in Pigs,” Gastrointestinal Endoscopy, Vol. 75, No. 4, 2012, pp. 849-855. doi:10.1016/j.gie.2011.11.039

[28]   Y. Saida, J. Nagao, Y. Nakamura, Y. Nakamura, T. Enomoto, M. Katagiri, et al., “A Comparison of Abdominal Cavity Bacterial Contamination of Laparoscopy and Laparotomy for Colorectal Cancers,” Digestive Surgery, Vol. 25, No. 3, 2008, pp. 198-201. doi:10.1159/000140689

[29]   M. M. Binda, C. R. Molinas, K. Mailova and P. R. Koninckx, “Effect of Temperature upon Adhesion Formation in a Laparoscopic Mouse Model,” Human Reproduction, Vol. 19, No. 11, 2004, pp. 2626-2632. doi:10.1093/humrep/deh495

[30]   M. M. Binda, C. R. Molinas, P. Hansen and P. R. Koninckx, “Effect of Desiccation and Temperature during Laparoscopy on Adhesion Formation in Mice,” Fertility and Sterility, Vol. 86, No. 1, 2006, pp. 166-175. doi:10.1016/j.fertnstert.2005.11.079

[31]   O. A. Elkelani, M. M. Binda, C. R. Molinas and P. R. Koninckx, “Effect of Adding More than 3% Oxygen to Carbon Dioxide Pneumoperitoneum on Adhesion Formation in a Laparoscopic Mouse Model,” Fertility and Sterility, Vol. 82, No. 6, 2004, pp. 1616-1622. doi:10.1016/j.fertnstert.2004.07.933