A Case of Pelvic Peritoneal Damage by Laparoscopy Instruments Revealed Under Scanning Electron Microscope (SEM)

The role of peritoneal membrane in human has been known in transport of fluids and electrolytes, host defense and reduce friction between bowels and other organs for a long time. This serosal layer consists of a single layer of mesothelial cells resting on basement membrane and submesothelial connective tissue with cell populations and structural proteins. In last decades, human pelvic peritoneum has been studied by using scanning electron microscopy in many conditions to diagnose the diseases especially in endometriosis, chronic pelvic pain and etc. In this study, microstructural changes caused by the surgeon due to unintentionally technical problems in tissue dissections is reported. This article presents unintentionally ultrastructural changes on the pelvic peritoneum during laparoscopic surgery by instruments that can lead to errors in diagnosis and understanding of the disease process for pathologist
Two pieces of involved peritoneal tissues with size of 7×7 mm and two pieces of apparently normal peritoneum were evaluated by scanning electron microscopy in a patient with chronic pelvic pain and suspected to endometriosis.
According to inadvertent damage of laparoscopic instruments to evaluate fine tissues such as peritoneum, this very simple but important tip should be noted during laparoscopic peritoneal tissue dissections for diagnostic and ultrastructural investigations.