Automated control for investigation of the insufflation-ventilation interaction in experimental laparoscopy

Willem van Weteringen, Frank Sterke, John Vlot, René M.H. Wijnen, Jenny Dankelman*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

In laparoscopic surgery the abdominal cavity is insufflated with pressurized carbon dioxide gas to create workspace. This pressure is exerted through the diaphragm onto the lungs, competing with ventilation and hampering it. In clinical practice the difficulty of optimizing this balance can lead to the application of harmfully high pressures. This study set out to create a research platform for the investigation of the complex interaction between insufflation and ventilation in an animal model. The research platform was constructed to incorporate insufflation, ventilation and relevant hemodynamic monitoring devices, controlling insufflation and ventilation from a central computer. The core of the applied methodology is the fixation of physiological parameters by applying closed-loop control of specific ventilation parameters. For accurate volumetric measurements the research platform can be used in a CT scanner. An algorithm was designed to keep blood carbon dioxide and oxygen values stable, minimizing the effect of fluctuations on vascular tone and hemodynamics. This design allowed stepwise adjustment of insufflation pressure to measure the effects on ventilation and circulation. A pilot experiment in a porcine model demonstrated adequate platform performance. The developed research platform and protocol automation have the potential to increase translatability and repeatability of animal experiments on the bio-mechanical interactions between insufflation and ventilation.

Original languageEnglish
Article numbere0285108
JournalPLoS ONE
Volume18
Issue number5 MAY
DOIs
Publication statusPublished - May 2023

Bibliographical note

Funding:
This research was supported by research
grants (J.V.) from Health~Holland, Top Sector Life
Sciences & Health (LSHM17063) and Merck Sharp
and Dohme (ISS57163). The funders had no role in
study design, data collection and analysis, decision
to publish, or preparation of the manuscript.

Publisher Copyright:
© 2023 van Weteringen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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