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Background: Tumor growth appears proportional to the pressure of carbon dioxide insufflation during laparoscopic surgery. Air and helium are alternative insufflation gases. The objective of this study is to assess tumor growth after air and helium insufflation at different pressures. Method: Ninety-six WAG rats were allocated to either air or helium. In both arms, rats were randomly exposed to a one hour gasless procedure, or to 4 mm Hg, 10 mm Hg, or 16 mm Hg insufflation. At the start of the procedure, 500,000 CC531 tumor cells were injected intraperitoneally. After three weeks, intraperitoneal tumor growth was assessed. Results: Higher insufflation pressures were associated with greater tumor growth. No difference of tumor growth between air and helium insufflation was found. Conclusion: In this experimental model, insufflation pressure appeared to have a greater impact on tumor growth than the type of gas. Further studies are necessary but it seems prudent to recommend employment of lower insufflation pressures in laparoscopic oncologic surgery. [ABSTRACT FROM AUTHOR]

Introduction: Port site metastases can occur when free viable tumor cells implant at trocar wounds. Irrigation of port sites with cytotoxic agents has been suggested to prevent port site metastases. The objective of this study is to assess whether tumor growth at port sites can be reduced by irrigation of these port sites. Methods: WAG rats were insufflated with CO2 for 20 minutes and 5 x 105 CC531 tumor cells were injected intraperitoneally. Port sites were irrigated after completion of the pneumoperitoneum with povidone-iodine, a mixture of taurolidine and heparin, or sodium chloride. Controls did not undergo any irrigation of port sites. In experiment 1, all 16 rats had all 4 irrigation modalities. In experiment 2, four groups of 20 rats had one type of irrigation on two trocar wounds. Tumor growth was evaluated 4 weeks after the procedure. Results: No difference in tumor growth at trocar wounds was found between any type of irrigation and controls in both experiments. Conclusion: In this experimental model, no beneficial or adverse effects of irrigation of port sites could be shown. [ABSTRACT FROM AUTHOR]