Effects of ıncreased ıntraabdomınal pressure whıle doıng laparoscopıc surgery to the dıaphragma

Aim: We aimed to invastigate the possible effects of increased intraabdominal pressure while doing laparoscopic surgery to the muscle contraction of diaphragma. Methods: There is three groups which has each eight rats have formed. Laparoscopy procedure has done for eight rats in group 1 that which was the control one. The other eight rats in group 2 have done laparoscopy for 60 minutes with 6 mmHg intraabdominal pressure and then they have been left for reperfusion for 30 minutes. The other eight rats in group 3 have done the same procedure with 12 mm Hg and then after the procedure diafragmatic muscle biopsy samples have taken from the same points of all rats of the each group. Ischemia-reperfusion damage has showen with acconting the tissue malondialdehyde levels, however histopathologic effect has showen with damage grading and biopsy scorring scales. To invastigate the muscle contraction of diaphragma, the pic amplitude ratios of the muscle biopsies have measured which have administered with electrical surface stimulus. Results: When the three groups? tissue malondialdehyde levels have compared there is no statistically significant differance between group 1 and group 2 (p= 0.027), but there is significant differance has found between group 1 and group 3 (p=0.002). There is no significant differance has found between group 2 and group 3 (p=0.074). The histopathological assessment of the muscle of diaphragma there have seen regular muscle fibres in group ones?samples. There was any pathological finding was seen between the muscle fibres. In group 2 samples of diaphragma muscles there were disorderies in patches and mild vasculer congestion have found in muscle fibres. However in group 3 samples of diaphragma muscles there were disorderies in patches and fragmentation has seen in muscle fibres. There were also enlargement of the interstitial field, vasocongestion and hemorrage have seen in muscle fibres. When the muscle contraction of diaphragma has approached that was found the function of diaphragmatic spasm has reduced in group 2 and group 3. Furthermore there is significant differance has found between group 2 and group 3 when the decline of spasm forces have compared (p<0.009). Conclusion: We found that the muscle of diapragma can be even affected with safe laparoscopic interval pressures which are accepted nowadays between 6 and 12 mmHg pressures with 60 minutes per a surgery, This affect can be occured with some potential mechanisms. These are the increased malondialdehyde levels because of the ischemia-reperfusion damage, the occured histopathological damage with exposed the direct pressure and as a result of the reduce of contraction. When the pressure levels increase with the increase of lacking function the myopathic damage can be the reason of diaphragmatic disfunction. Key Words: Laparoscopy, intraabdominal pressure, diaphragma, malondialdehyde, contraction.