Alper Biler 1, A–F , Sait Yucebilgin 2, A–F , Fatih Sendag 2, A–F , Levent Akman 2, A–F , Ali Akdemir 2, A–F , Utku Ates 3, A–C, E, F , Yigit Uyanikgil 3, A–C, E, F , Ozlem Yilmaz-Dilsiz 3, A–C, E, F , Ebru Sezer 4, A–C, E, F The Effects of Different Intraabdominal Pressure Protocols in Laparoscopic Procedures on Oxidative Stress Markers and Morphology in Rat Ovaries 1 Fatsa Gynecology and Maternity Training and Research Hospital of TC Ministry of Health, Ordu, Turkey 2 Department of Obstetrics and Gynecology, Faculty of Medicine, Ege University, Bornova, İzmir, Turkey 3 Department of Histology and Embryology, Faculty of Medicine, Ege University, Bornova, İzmir, Turkey 4 Department of Biochemistry, Faculty of Medicine, Ege University, Bornova, İzmir, Turkey A – research concept and design; B – collection and/or assembly of data; C – data analysis and interpretation; D – writing the article; E – critical revision of the article; F – final approval of article; G – other Abstract Background. To determine the effects of different intraabdominal pressure (IAP) on the ovaries in a laparoscopic rat model. Objectives. The aim of the study was to determine the effects on the ovaries of different intraabdominal pressures (IAP) in laparoscopic surgery in a rat model. Material and Methods. Thirty-two post-pubertal nonpregnant Sprague-Dawley rats were divided randomly into four groups. In the control group, no intraabdominal pressure (IAP) was applied. In Group Pp10 and Group Pp15, an IAP of 10 and 15 mm Hg, respectively, were applied by carbon dioxide insufflation for 60 min, and a 30-min desufflation was carried out. In Group IPp15, a 15 mm Hg IAP was applied for 10 min, and then CO 2 was desufflated for 10 min. After this ischemic preconditioning, IAP was established at 15 mm Hg for 60 min, after which CO 2 was desufflated for 30 min. Erythrocyte and ovarian tissue malondialdehyde (MDA) and histopathologic damage scores were evaluated. Results. In Groups Pp10 and Pp15, ovarian tissue MDA values were significantly increased compared to the con- trol group. In Groups Pp10 and Pp15, erythrocyte MDA values were significantly increased when compared to Group IPp15 and the control group. Ovarian histopatological assesment scores were significantly higher in Group Pp15 than in Groups Pp10 and IPp15. Conclusions. Pneumoperitoneum causes injuries to abdominal organ such as the ovaries. The ischemic precon- ditioning method is more effective in reducing oxidative stress due to laparoscopic pneumoperitoneum than low- pressure pneumoperitoneum methods (Adv Clin Exp Med 2014, 23, 6, 885–892). Key words: ischemic preconditioning, pneumoperitoneum, oxidative stress, reperfusion, laparoscopy. Adv Clin Exp Med 2014, 23, 6, 885–892 ISSN 1899–5276 ORIGINAL PAPERS © Copyright by Wroclaw Medical University As skills and knowledge in diagnostic lapa- roscopy have improved and more advanced sur- gical instruments have been developed, the use of laparoscopic techniques has become much more common and has earned the admiration of the majority of surgeons. More complex pro- cedures are being performed via laparoscopy, including traditional abdominal hysterectomy. As laparoscopic surgery has developed and surgeons have gained more experience, the procedure has been extended to the pregnant population. The most common reported laparoscopic operations during pregnancy are cholecystectomy, adnexial surgery, appendectomy and management of het- erotopic pregnancy [1]. In laparoscopic techniques, a working space is established by insuffling a gas into the abdom- inal cavity. However, pneumoperitoneum (PN) is