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pneumoperitoneum effects

Safinaz Karabayirli, Onder Surgit, Hulya Kasikara, Cemile Koca Bicer, Merve Ergin, Ruveyda Irem Demircioglu, Bunyamin Muslu
BACKGROUND: The aim of the study was to explore the differences in oxidative stress during anesthesia with desflurane/N2O or propofol/remifentanil in patients undergoing laparoscopic cholecystectomy and additionally to evaluate the differential effects of desflurane and propofol on ischemic preconditioning (IP). MATERIALS AND METHODS: One hundred patients were randomly allocated to four groups. For anesthesia maintenance, the inhalation group (Group I) and the inhalation plus IP group (Group IIP) received desflurane at an end-tidal concentration of 4-6 vol% in oxygen/N2O, and the TIVA group (Group T) and TIVA plus IP group (Group TIP) received infusions of propofol and remifentanil...
October 24, 2016: Acta Chirurgica Belgica
Daniel W Birch, Jerry T Dang, Noah J Switzer, Namdar Manouchehri, Xinzhe Shi, Ghassan Hadi, Shahzeer Karmali
BACKGROUND: Intraoperative hypothermia during both open and laparoscopic abdominal surgery may be associated with adverse events. For laparoscopic abdominal surgery, the use of heated insufflation systems for establishing pneumoperitoneum has been described to prevent hypothermia. Humidification of the insufflated gas is also possible. Past studies on heated insufflation have shown inconclusive results with regards to maintenance of core temperature and reduction of postoperative pain and recovery times...
October 19, 2016: Cochrane Database of Systematic Reviews
Xming Yang, Jie Xie, Jun Liu, Tao Wang
This study aims to study the impact of dexmedetomidine on the deformability of erythrocyte in patients with laparoscopic cholecystectomy. 40 patients scheduled for laparoscopic cholecystectomy were randomly divided into 2 groups: Dexmedetomidine group (0.5µg/kg loading within 10 min and 0.5μg•kg-1•h-1maintenance to the end of pneumoperitoneum, n=20, Group A) and control group (normal saline at the identical, n=20, Group B). The induction and maintenance of anesthesia of two groups were identical. Erythrocyte deformability index (EI) and haematocrit (Hct) were assayed before anesthesia and after the operation...
September 2016: Pakistan Journal of Pharmaceutical Sciences
Xixue Zhang, Jionglin Wei, Xiaoxing Song, Yuhao Zhang, Weiqing Qian, Lu Sheng, Zhoujun Shen, Lvjun Yang, Rong Dong, Weidong Gu
BACKGROUND: Robot-assisted laparoscopic radical prostatectomy and robot-assisted radical cystectomy have gradually become the preferred choices for urologists as they allow surgeons to perform complex procedures more precisely and effectively. The pneumoperitoneum, which is normally applied in these surgeries to provide visual clarity and space to perform the procedure, may cause hemodynamic disturbance, potentially myocardial injury. Thus surgeons have recently considered opting for the low-pressure pneumoperitoneum to lower this negative impact...
October 10, 2016: Trials
Javier Barrio, Carlos L Errando, Guillermo San Miguel, Boris I Salas, Juan Raga, José L Carrión, Jaime García-Ramón, Juan Gallego
STUDY OBJECTIVE: To evaluate the effect of neuromuscular blockade (NMB) upon the abdominal space during pneumoperitoneum establishment in laparoscopic surgery, comparing moderate NMB and deep NMB. DESIGN: Prospective, randomized, crossover clinical trial. SETTING: Operating room. PATIENTS: Seventy-six American Society of Anesthesiologists 1 to 2 patients scheduled for elective laparoscopic surgery. INTERVENTIONS: Two independent evaluations were performed at the establishment of pneumoperitoneum for a preset intraabdominal pressures (IAPs) of 8 and 12 mm Hg, both during moderate NMB (train-of-four count, 1-3) and deep NMB (posttetanic count, <5)...
November 2016: Journal of Clinical Anesthesia
Osama M Assad, Ayman A El Sayed, Mohamed A Khalil
STUDY OBJECTIVE: To analyze the effects of pressure-controlled ventilation-volume guaranteed (PCV-VG) and volume controlled ventilation (VCV) on airway pressures and respiratory and circulatory indicators during laparoscopic surgery in Trendelenburg position. DESIGN: Prospective randomized comparative clinical study. SETTING: Tertiary hospital. PATIENTS: Forty ASA physical status 1 and 2 patients who underwent elective laparoscopic surgery in Trendelenburg position...
November 2016: Journal of Clinical Anesthesia
Maria Grazia Sederino, Giulia Casamassima, Rita Laforgia, Giovanni Balducci, Giuseppe Carbotta, Antonella Tromba
AIM: This study is aimed to evaluate the incidence of the postoperative deep vein thrombosis (DVT) and the cell damage from compartment iatrogenic syndrome, analyzing two groups of patients operated laparoscopically, one of which assisted with a Sequential Compression Device (SCD). MATERIAL OF STUDY: A patients' series submitted to laparoscopic surgery over a period at least 90 minutes. The venous flow in the lower limbs was detected with the Echo Colour Doppler method, and only one of the two groups was assisted with the SCD...
2016: Annali Italiani di Chirurgia
Petros Ypsilantis, Constantinos Simopoulos
BACKGROUND: Laparoscopic partial hepatectomy is an increasingly applied technique in the treatment of liver tumors and in living donor transplantation. There is a need for establishing an animal model that would facilitate experimental research on the technique. The aim of the present study was to describe a safe and efficient laparoscopic technique of 70% partial hepatectomy in the rat. MATERIALS AND METHODS: Twenty-four male Wistar rats underwent either laparoscopic (group LAP-HEP) or open resection of the median and left lateral hepatic lobes (group HEP)...
October 2016: Journal of Surgical Research
Turgut Donmez, Sinan Uzman, Dogan Yildirim, Adnan Hut, Huseyin Imam Avaroglu, Duygu Ayfer Erdem, Erdinc Cekic, Fazilet Erozgen
BACKGROUND: Laparoscopic cholecystectomies (LC) are generally performed in a 12 mmHg-pressured pneumoperitoneum in a slight sitting position. Considerable thromboembolism risk arises in this operation due to pneumoperitoneum, operation position and risk factors of patients. We aim to investigate the effect of pneumoperitoneum pressure on coagulation and fibrinolysis under general anesthesia. MATERIAL AND METHODS: Fifty American Society of Anesthesiologist (ASA) I-III patients who underwent elective LC without thromboprophlaxis were enrolled in this prospective study...
2016: PeerJ
Dong Hui Cho, Sang Soo Lee, Dongwook Oh, Tae Jun Song, Do Hyun Park, Dong Wan Seo, Sung Koo Lee, Myung-Hwan Kim
BACKGROUND AND AIMS: Although fully covered self-expandable metal stents (FCSEMSs) have been commonly used for EUS-guided biliary drainage (EUS-BD), FCSEMSs migration is a main limitation of this procedure. In the present study, we evaluated the technical and clinical success rates, adverse events and long-term outcomes of a newly developed hybrid stent that has been customized for EUS-BD. METHOD: From September 2011 to May 2015, a total of 54 consecutive patients with biliary obstruction were enrolled in this prospective, observational study...
September 17, 2016: Gastrointestinal Endoscopy
Oscar M Crespin, Louis W C Liu, Ambica Parmar, Timothy D Jackson, Jemila Hamid, Eran Shlomovitz, Allan Okrainec
INTRODUCTION: Peroral endoscopic myotomy (POEM) is a novel intervention for the treatment of achalasia, which combines the advantages of endoscopic access and myotomy. The purpose of this study was to perform a systematic review of the literature to evaluate the efficacy and safety of POEM. METHODS: The systematic review was conducted following the PRISMA guidelines. Evidence-Based Medicine Reviews, Cochrane Central Register of Controlled Trials, Ovid MEDLINE (R) including in-process and non-indexed citations were searched for POEM studies using the keywords: esophageal achalasia, POEM, endoscopy, natural orifice surgery, laparoscopic Heller myotomy (LHM), and related terms...
September 15, 2016: Surgical Endoscopy
Shoko Nakano, Junko Nakahira, Toshiyuki Sawai, Noriko Kadono, Toshiaki Minami
BACKGROUND: Robot-assisted laparoscopic prostatectomy is increasingly performed as a minimally invasive option for patients with organ-confined prostate cancer. This technique offers several advantages over other surgical methods. However, concerns have been raised over the effects of the steep head-down tilt necessary during the procedure. We present a case in which head-down positioning and abdominal insufflation masked the signs of an intraoperative hemorrhage. CASE PRESENTATION: A 73-year-old Asian man developed severe hypotension caused by an unexpected hemorrhage during robot-assisted laparoscopic prostatectomy for prostate cancer...
2016: Journal of Medical Case Reports
Aya Doe, Motoi Kumagai, Yuichiro Tamura, Akira Sakai, Kenji Suzuki
PURPOSE: Steep Trendelenburg position and pneumoperitoneum during robotic-assisted laparoscopic prostatectomy (RALP) increase intracranial pressure (ICP) and may alter cerebral blood flow (CBF) and oxygenation. Volatile anesthetics and propofol have different effects on ICP, CBF, and cerebral metabolic rate and may have different impact on cerebral oxygenation during RALP. In this study, we measured jugular venous bulb oxygenation (SjO2) and regional oxygen saturation (SctO2) in patients undergoing RALP to evaluate cerebral oxygenation and compared the effects of sevoflurane and propofol...
August 26, 2016: Journal of Anesthesia
Chuck Becker, Margaret A Plymale, John Wennergren, Crystal Totten, Kyle Stigall, J Scott Roth
BACKGROUND: To provide adequate workspace between the viscera and abdominal wall, insufflation with carbon dioxide is a common practice in laparoscopic surgeries. An insufflation pressure of 15 mmHg is considered to be safe in patients, but all insufflation pressures create perioperative and postoperative physiologic effects. As a composition of viscoelastic materials, the abdominal wall should distend in a predictable manner given the pressure of the pneumoperitoneum. The purpose of this study was to elucidate the relationship between degree of abdominal distention and the insufflation pressure, with the goal of determining factors which impact the compliance of the abdominal wall...
August 23, 2016: Surgical Endoscopy
Hüseyin Ulaş Pınar, Rafi Doğan, Ümmü Mine Konuk, Egemen Çifci, Enes Duman, Erdal Karagülle, Emin Türk, Ömer Karaca
BACKGROUND: Increased central venous pressure secondary to an increase in intraabdominal pressure has been reported during laparoscopic surgery. However, no study has yet determined the effect of pneumoperitoneum on cross-sectional area (CSA) of central veins by ultrasonography during laparoscopic cholecystectomy. Herein, we aimed to quantify changes in CSAs of internal jugular (IJV) and subclavian veins (SCV) by ultrasonography during this surgery. METHODS: This study included 60 ASA I-II patients scheduled for laparoscopic cholecystectomy surgery under general anesthesia...
2016: BMC Anesthesiology
Makoto Sato, Atsushi Kurosawa, Tomoki Sasakawa, Takayuki Kunisawa, Osamu Takahata, Hiroshi Iwasaki
BACKGROUND: The aim of this study was to investigate whether changes in perfusion index (PI) correlate with non-invasive haemodynamic parameters (HR, BP) following the onset of pneumoperitoneum under two doses (moderate-dose (MD) and high-dose (HD)) of remifentanil and to compare its reliability. METHODS: We divided 33 patients who were scheduled for laparoscopic surgery under general anesthesia into two groups according to the dose of continuously infused remifentanil: moderate dose 0...
June 2016: Masui. the Japanese Journal of Anesthesiology
Philipp D Mayhew, Kathryn A Pitt, Michele A Steffey, William T N Culp, Philip H Kass, Stanley L Marks
OBJECTIVE To evaluate the effect of intra-abdominal pressure (IAP) on morphology and compliance of the lower esophageal sphincter (LES) by use of impedance planimetry in healthy dogs and to quantify the effect of changes in IAP. ANIMALS 7 healthy, purpose-bred sexually intact male hound-cross dogs. PROCEDURES Dogs were anesthetized, and cross-sectional area (CSA), minimal diameter (MD), LES length, LES volume, and distensibility index (DI) of the LES were evaluated by use of an endoscopic functional luminal imaging probe...
August 2016: American Journal of Veterinary Research
Hemanga K Bhattacharjee, Azarudeen Jalaludeen, Virinder Bansal, Asuri Krishna, Subodh Kumar, Rajeshwari Subramanium, Rashmi Ramachandran, Mahesh Misra
BACKGROUND: The incidence of shoulder pain (SP) following laparoscopic cholecystectomy (LC) varies between 21 and 80 %. A few randomised controlled trials and meta-analysis have shown lesser SP in LC performed under low-pressure carbon dioxide pneumoperitoneum (LPCP) than under standard-pressure carbon dioxide pneumoperitoneum (SPCP). However, the possible compromise in adequate exposure and effective working space during LPCP has negatively influenced its uniform adoption for LC. MATERIALS AND METHODS: All consecutive patients undergoing elective LC for gallstone disease who met the inclusion and exclusion criteria were enroled...
July 21, 2016: Surgical Endoscopy
Rodrigo C Surjan, Fabio F Makdissi, Tiago Basseres, Denise Leite, Luiz F Charles, Regis O Bezerra, Erik Schadde, Marcel Autran Machado
BACKGROUND: ALPPS (Associating Liver Partition and Portal vein ligation for Staged hepatectomy) is a new surgical approach for the treatment of liver tumors. It is indicated in cases where the future liver remnant is not sufficient to maintain postoperative liver function. We report a totally laparoscopic ALPPS with selective hepatic artery clamping. Pneumoperitoneum itself results in up to 53% of portal vein flow and selective hepatic artery clamping can reduce blood loss while maintaining hepatocellular function...
July 2016: Medicine (Baltimore)
Rodolfo Alejandro Fuentes-Reyes, Mariel Fernanda Pacheco-Patiño, Aurora Natalia Ponce-Escobedo, Gerardo Enrique Muñoz-Maldonado, Marco Antonio Hernandez-Guedea
BACKGROUND: Laparoscopic surgery has begun to replace a great number of procedures that were previously practiced using open or conventional techniques. This is due to the minimal invasion, small incisions, and short time recovery. However, it has come to knowledge, that the increase in intra-abdominal pressure due to carbon dioxide pneumoperitoneum during laparoscopic surgery causes cardiovascular, respiratory, endocrine, and renal alterations. OBJECTIVE: To evaluate the nephroprotective effect of telmisartan, an angiotensin II AT1 receptor antagonist, on glomerular filtration in laparoscopic surgery...
July 11, 2016: Cirugia y Cirujanos
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