Laparoscopy and tribology: the effect of laparoscopic gas on peritoneal fluid.
STUDY OBJECTIVE: To assess the changes in viscosity of peritoneal fluid during laparoscopic exposure to CO2 insufflation. DESIGN: Analysis and mathematic modeling of peritoneal fluid viscosity in vivo and in vitro as a result of exposure to unconditioned CO2 (Canadian Task Force classification II-2). SETTING: Medical school university research laboratory and hospital. MATERIALS: Peritoneal fluid from 45 women. INTERVENTION: Peritoneal fluid was obtained at laparoscopy before insufflation and tested for viscosity after exposure to currently used raw dry unconditioned CO2. MEASUREMENTS AND MAIN RESULTS: Peritoneal fluid viscosity was tested by viscometric methods and mathematic modeling. Initial viscosity of peritoneal fluid before gas exposure was 1.425 centipoise (cP). Viscosity measurements were obtained at 20-second intervals for gas flows of 1 and 3 L/minute. Increases in viscosity occur rapidly, and by 200 seconds it was 59 cP and 98 cP for 1 and 3 L flow rates, respectively. CONCLUSION: Very dry CO2 for laparoscopy causes peritoneal fluid viscosity to increase dramatically. (J Am Assoc Gynecol Laparosc 8(1):117-123, 2001)