Abstract: To investigate the fibrinolytic changes in peritoneal biopsies during laparoscopic and conventional abdominal surgeries. MethodsIn laparotomies, peritoneal biopsies were taken when the abdomen was opened and just before being closed. In laparoscopies, peritoneal biopsies were opened after carbon dioxide insufflation and were closed just before exsufflation. Concentrations of tissuetype plasminogen activator (tPA), plasminogen activator inhibitor type 1 (PAI-1) and the resulting tPA activity were determined. ResultsConcentrations of tPA in peritoneal tissues decreased during operations in both groups, but was more significantly in the laparotomy group (P<0.05). PAI-1 levels in opening biopsies were higher in the laparoscopy group than that in the laparotomy group (P<0.05). PAI-1 concentrations were also increased in laparotomies but not in laparoscopies. At the end of the operations, there were no differences between the two groups. The resulting tPA activity did not differ between the two groups at opening or closure, but it was decreased in both groups during operations (P<0.05). ConclusionThese findings indicate that the peritoneal response to open and laparoscopic surgeries is similar. The initial rise in peritoneal PAI-1 concentration during laparoscopies suggests adverse effects of carbon dioxide insufflation, which might affect peritoneal repair.

Key words: Laparoscopes, Tissue plasminogen activator, Plasminogen activator inhibitor 1, Urinary plasminogen activator