Local and systemic pleuric -peritoneal and biohumoral changes and risk of post-surgical environmental contamination in children (0 -16 years) undergoing minimally invasive surgery

Brief description of the proposal

CO2-insufflation during minimally invise procedures causes distension of the abdominal and thoracic cavity. Mechanical and biochemical stimuli can modify the peritoneal and pleural environment and promote inflammatory infiltration. Given the widespread use of minimally invasive techniques even in children, it is important to verify whether the CO2-insufflation induces local morphological changes of the peritoneum and pleura, and systemic alterations. The study of serosa cell infiltrates and the identification of local and systemic mediators that regulate inflammatory cells may be responsible for the clinical symptoms reported by patients undergoing this technique, and therefore their prevention could represent an important means of treatment. Furthermore, evaluating the possible environmental contamination after CO2 evacuation is important for the safety of components of the operating room.

Based on this background we aim to:

1) investigate the impact of MIS on human mesothelium in terms of inflammatory response, cellular changes, and oxidative stress;

2) verify the systemic changes in cytokines levels after MIS in childhood;

3) evaluate difference between clear and dirty MIS in environmental contamination;

4) identify possible cross-infection from patients to healthcare workers.