Analyzing the effect of laparoscopy duration time on peroperative gastroesophageal reflux

Abstract

Background/aim: Intraabdominal pressure (IAP) is one of the main reasons for gastroesophageal reflux (GER). This study investigateswhether IAP during laparoscopic surgery leads to GER in a time-dependent manner.Materials and methods: In a laparoscopy model, 15 mmHg IAP was created in 8 Wistar albino rats in the Trendelenburg position(TP). A 5 mm laparotomy was performed in the left lower abdominal region, and a 6 Fr catheter was placed intraabdominally. Air wasinsufflated into the abdominal cavity, and the pressure was kept constant at 15 mmHg. Esophageal pH alterations were measured by pHsticks for 4 h every 30 min.Results: The basal median esophageal pH value was 9 (8–10), the value after placing the catheter was 9 (7–10) (P = 0.47), and the medianpH value after placing the subjects in TP was 9 (8–10) (P = 0.70). In our experimental model, esophageal pH values were found todecrease significantly at the 150th minute in TP and at 15 mmHg IAP (P 0.05).Conclusion: Esophageal pH values decreased and continued to remain low following IAP increase and TP in this experimental ratmodel. Prolonged laparoscopic procedures can particularly lead to GER that requires instant recognition and rapid and appropriateintervention.