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pneumoperitoneum effects

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https://www.readbyqxmd.com/read/28802605/laparoscopic-cholecystectomy-under-neuraxial-anesthesia-compared-with-general-anesthesia-systematic-review-and-meta-analyses
#1
REVIEW
Marcelo A Longo, Bárbara T Cavalheiro, Getúlio R de Oliveira Filho
BACKGROUND: Pneumoperitoneum during laparoscopic cholecystectomy (LC) can cause hypercapnia, hypoxemia, hemodynamic changes and shoulder pain. General anesthesia (GA) enables the control of intraoperative pain and ventilation. The need for GA has been questioned by studies suggesting that neuraxial anesthesia (NA) is adequate for LC. STUDY OBJECTIVE: To quantify the prevalence of intraoperative pain and to verify whether evidence on the maintenance of ventilation, circulation and surgical anesthesia during NA compared with GA is consistent...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28767501/endoscopic-gastroenterostomy-techniques-and-review
#2
Shayan Irani, Todd H Baron, Takao Itoi, Mouen A Khashab
PURPOSE OF REVIEW: Gastric outlet obstruction (GOO) can result from benign and malignant causes. Until recently, surgical gastrojejunostomy was the treatment of choice for patient with benign and malignant GOO with a good functional status. Endoscopic placement of luminal self-expandable metal stents is currently widely accepted as the first line of treatment for malignant GOO because of its effectiveness and minimally invasive nature. The main shortcoming of luminal stents is the high incidence of recurrent GOO most commonly because of tumor ingrowth/overgrowth...
September 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28757826/an-observational-study-effects-of-tenting-of-the-abdominal-wall-on-peak-airway-pressure-in-robotic-radical-prostatectomy-surgery
#3
Avinash Sahebarav Kakde, Harshal D Wagh
BACKGROUND: Robotic radical prostatectomy (RRP) is associated with various anesthetic challenges due to pneumoperitoneum and deep Trendelenburg position. Tenting of the abdominal wall done in RRP surgery causes decrease in peak airway pressure leading to better ventilation. Herein, we aimed to describe the effects of tenting of the abdominal wall on peak airway pressure in RRP surgery performed in deep Trendelenburg position. METHODS: One hundred patients admitted for RRP in Kokilaben Dhirubhai Ambani Hospital of American Society of Anesthesiologists 1 and 2 physical status were included in the study...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28741716/influence-of-lateral-position-and-pneumoperitoneum-on-oropharyngeal-leak-pressure-with-two-types-of-laryngeal-mask-airways
#4
S Lan, Y Zhou, J T Li, Z Z Zhao, Y Liu
BACKGROUND: An important parameter to monitor adequate ventilation for laryngeal mask airway (LMA) is its oropharyngeal leak pressure (OLP). This study was designed to evaluate and compare the effect of lateral position and pneumoperitoneum on the OLP and ventilation efficiency between LMA™ Proseal (PLMA) and LMA™ Supreme (SLMA). METHODS: Patients were randomized to receive either the PLMA or the SMLA. The OLP was assessed in both the supine position and the lateral position with or without pneumoperitoneum...
July 25, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28734974/the-effects-of-pneumoperitoneum-and-the-steep-trendelenburg-position-on-heart-rate-variability-and-cerebral-oxygenation-during-robotic-sacrocolpopexy
#5
Emad Matanes, Amir Weissman, Aleksandr Rivlin, Roy Lauterbach, Amnon Amit, Zeev Wiener, Lior Lowenstein
STUDY OBJECTIVE: The aim of the current study was to investigate how steep Trendelenburg positioning with pneumoperitoneum modifies brain oxygenation and autonomic nervous system modulation of heart rate variability during robotic sacrocolpopexy. DESIGN: A 5-minute computerized ECG, cerebral O2 saturation (cSO2), systemic O2 saturation (sSO2), heart rate (HR), diastolic blood pressure (BP), systolic BP and end tidal CO2 tension were recorded immediately after anesthesia induction (baseline phase) and after alterations in positioning and in intra-abdominal pressure...
July 19, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28733748/preoperative-botulinum-toxin-a-enabling-defect-closure-and-laparoscopic-repair-of-complex-ventral-hernia
#6
Omar Rodriguez-Acevedo, Kristen E Elstner, Anita S W Jacombs, John W Read, Rodrigo Tomazini Martins, Fernando Arduini, Michael Wehrhahm, Colette Craft, Peter H Cosman, Anthony N Dardano, Nabeel Ibrahim
INTRODUCTION: Operative management of complex ventral hernia still remains a significant challenge for surgeons. Closure of large defects in the unprepared abdomen has serious pathophysiological consequences due to chronic contraction and retraction of the lateral abdominal wall muscles. We report outcomes of 56 consecutive patients who had preoperative Botulinum toxin A (BTA) abdominal wall relaxation facilitating closure and repair. METHODS: This was a prospective observational study of 56 patients who underwent ultrasound-guided BTA into the lateral abdominal oblique muscles prior to elective ventral hernia repair between November 2012 and January 2017...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28730774/laparoscopic-colectomy-for-serosa-positive-colon-cancer-pt4a-in-patients-with-preoperative-diagnosis-of-cancer-without-serosal-invasion
#7
Shenglong Guo, Detao Tang, Xiaojun Chen, Ming Chen, Yaqian Xiang
PURPOSE: Although general surgeons normally perform laparoscopic colectomies in patients with colon cancer, the procedure is also indicated for serosa-negative tumors (≤ cT3). Serosal invasion (T4a) is regarded as a potential risk factor for peritoneal dissemination due to pneumoperitoneum effects and tumor manipulation during laparoscopic colectomy. We compared short- and long-term outcomes of patients who underwent laparoscopic and open colectomies for serosa-involving colon cancer (pT4a) and had a preoperative diagnosis of cancer without serosal invasion (≤cT3)...
May 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28708771/effect-of-clonidine-on-hemodynamic-responses-during-laparoscopic-cholecystectomy-a-systematic-review-and-meta-analysis
#8
Yi Zhang, Xi Zhang, Yu Wang, Jiefeng Zhang
BACKGROUND: Clonidine might be beneficial to the patients undergoing laparoscopic cholecystectomy. This meta-analysis focused on the influence of clonidine on hemodynamic responses in patients undergoing laparoscopic cholecystectomy. METHODS: We searched several databases including PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases. This meta-analysis included randomized controlled trials regarding the influence of clonidine versus placebo on laparoscopic cholecystectomy...
July 13, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28679201/physiological-effects-of-the-open-lung-approach-during-laparoscopic-cholecystectomy-focus-on-driving-pressure
#9
Davide D'Antini, Michela Rauseo, Salvatore Grasso, Lucia Mirabella, Luigi Camporota, Antonella Cotoia, Savino Spadaro, Alberto Fersini, Rocco Petta, Rosaria Menga, Alberto Sciusco, Michele Dambrosio, Gilda Cinnella
BACKGROUND: During laparoscopy, respiratory mechanics and gas exchange are impaired because of pneumoperitoneum and atelectasis formation. We applied an open lung approach (OLA) consisting in lung recruitment followed by a decremental positive-end expiratory pressure (PEEP) trial to identify the level of PEEP corresponding to the highest compliance of the respiratory system (best PEEP). Our hypothesis was that this approach would improve both lung mechanics and oxygenation without hemodynamic impairment...
July 5, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28669704/low-pressure-robot-assisted-radical-prostatectomy-with-the-airseal-system-at-olv-hospital-results-from-a-prospective-study
#10
Sabrina La Falce, Giacomo Novara, Giorgio Gandaglia, Paolo Umari, Geert De Naeyer, Frederiek D'Hondt, Jean Beresian, Rik Carette, Martin Penicka, Yujiing Mo, Geert Vandenbroucke, Alexandre Mottrie
BACKGROUND: Limited studies examined effects of pneumoperiotneum during robot-assisted radical prostatectomy (RARP) and with AirSeal. The aim of this study was to assess the effect on hemodynamics of a lower pressure pneumoperitoneum (8 mmHg) with AirSeal, during RARP in steep Trendelenburg 45° (ST). MATERIALS AND METHODS: This is an institutional review board-approved, prospective, interventional, single-center study including patients treated with RARP at OLV Hospital by one extremely experienced surgeon (July 2015-February 2016)...
June 2, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28665139/intraoperative-retrograde-perfusion-sphincterometry-to-evaluate-efficacy-of-autologous-vas-deferens-6-branch-suburethral-sling-to-properly-restore-sphincteric-apparatus-during-robot-assisted-radical-prostatectomy
#11
Andrea Cestari, Davide Soranna, Giuseppe Zanni, Antonella Zambon, Matteo Zanoni, Mattia Sangalli, Massimo Ghezzi, Fabio Fabbri, Francesco Sozzi, Vincenzo Dell'Acqua, Patrizio Rigatti
OBJECTIVE: The aim of this study is to describe (urodynamically) the effect of the use of a 6-branch autologous suburethral sling, made with absorbable sutures and vas deferens, to support the bladder neck and urethra during robot-assisted laparoscopic prostatectomy (RALP) to improve early urinary continence (EUC) recovery. MATERIALS AND METHODS: Retrograde leak point pressure (RLPP) was intraoperatively evaluated, by means of retrograde perfusion sphincterometry (RPS), in 77 patients (mean age ± standard deviation [SD]: 65...
July 31, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28658879/attenuation-of-haemodynamic-parameters-in-response-to-pneumoperitoneum-during-laparoscopic-cholecystectomy-a-randomized-controlled-trial-comparing-infusions-of-propofol-and-dexmedetomidine
#12
Meyong Pincho Bhutia, Arati Rai
INTRODUCTION: Effective control of sympathetic response to pneumoperitoneum is vital to avoid morbidity in patients undergoing laparoscopic surgeries. This control must be achieved without any side effects of the drugs being used as well as ensuring a raid recovery from anaesthesia in order to maximise operation theatre utility. AIM: To study the effectiveness of dexmedetomidine in attenuating the haemodynamic response to pneumoperitoneum during laparoscopic cholecystectomy (using only the maintenance dose) with that of propofol and compare time to extubation, haemodynamics on extubation, sedation score after extubation and any incidence of side effects between the two study drug...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28639043/ultrasonographic-optic-nerve-sheath-diameter-for-predicting-elevated-intracranial-pressure-during-laparoscopic-surgery-a-systematic-review-and-meta-analysis
#13
Eun Jung Kim, Bon-Nyeo Koo, Seung Ho Choi, Kyoungun Park, Min-Soo Kim
BACKGROUND: Laparoscopic surgery involves the creation of a carbon dioxide (CO2) pneumoperitoneum to facilitate a clear surgical view, which may result in an elevated intracranial pressure (ICP). Depending on the surgical area, steep Trendelenburg positioning may be used as well, further increasing the ICP. The objective of this study was to assess the effects of laparoscopic surgery on changes in ICP assessed by ultrasonographic measurement of optic nerve sheath diameter (ONSD), which is a generally accepted simple, reliable, and non-invasive ICP measurement technique...
June 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28635028/gases-for-establishing-pneumoperitoneum-during-laparoscopic-abdominal-surgery
#14
REVIEW
Tianwu Yu, Yao Cheng, Xiaomei Wang, Bing Tu, Nansheng Cheng, Jianping Gong, Lian Bai
BACKGROUND: This is an update of the review published in 2013.Laparoscopic surgery is now widely performed to treat various abdominal diseases. Currently, carbon dioxide is the most frequently used gas for insufflation of the abdominal cavity (pneumoperitoneum). Although carbon dioxide meets most of the requirements for pneumoperitoneum, the absorption of carbon dioxide may be associated with adverse events. People with high anaesthetic risk are more likely to experience cardiopulmonary complications and adverse events, for example hypercapnia and acidosis, which has to be avoided by hyperventilation...
June 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28630240/port-site-endometrioma-a-rare-cause-of-abdominal-wall-pain-following-laparoscopic-surgery
#15
Zohaib A Siddiqui, Fahd Husain, Zain Siddiqui, Midhat Siddiqui
Endometriomas are a rare cause of abdominal wall pain. We report a case of a port site endometrioma presenting with an umbilical swelling. The patient underwent a laparoscopy for pelvic endometriosis 6 months previously and presented with a swelling around her umbilical port site scar associated with cyclical pain during menses. Ultrasound scan reported a well-defined lesion in the umbilicus and MRI scanning excluded other pathology. As she was symptomatic, she underwent an exploration of the scar and excision of the endometrioma with resolution of her symptoms...
June 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28607287/does-carbon-dioxide-pneumoperitoneum-affect-the-renal-function-in-donors-following-laparoscopic-donor-nephrectomy-a-prospective-study
#16
Murali Vinodh, Vijaykumar Mohankumar, Arvind Ganpule, Banibrata Mukhopadhyay, Ravindra Sabnis, Mahesh Desai
CONTEXT: Although the technical feasibility of laparoscopic donor nephrectomy (LDN) has been established, concerns have been raised about the impaired renal function resulting from pneumoperitoneum and its short- and long-term effects. AIMS: We used urinary biomarkers of acute kidney injury including urinary neutrophil gelatinase-associated lipocalin (uNGAL) and urinary N-acetyl-beta-D-glucosaminidase (uNAG) to study the injury caused to the donor's retained kidney by pneumoperitoneum...
July 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28594257/mri-evaluation-of-an-elastic-tpu-mesh-under-pneumoperitoneum-in-ipom-position-in-a-porcine-model
#17
A Lambertz, L C L van den Hil, A Ciritsis, R Eickhoff, N A Kraemer, N D Bouvy, A Müllen, U Klinge, U P Neumann, C D Klink
BACKGROUND: The frequency of laparoscopic approaches increased in hernia surgery over the past years. After mesh placement in IPOM position, the real extent of the meshes configurational changes after termination of pneumoperitoneum is still largely unknown. To prevent a later mesh folding it might be useful to place the mesh while it is kept under tension. Conventionally used meshes may lose their Effective Porosity under these conditions due to poor elastic properties. The aim of this study was to evaluate a newly developed elastic thermoplastic polyurethane (TPU) containing mesh that retains its Effective Porosity under mechanical strain in IPOM position in a porcine model...
June 8, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28585913/a-case-of-recurrent-pneumoperitoneum-and-pneumatosis-intestinalis-after-bilateral-lung-transplant
#18
Oliver Beetz, Moritz Kleine, Florian Wolfgang Rudolf Vondran, Sebastian Cammann, Jürgen Klempnauer, Bastian Kettler
We report a case of a 60-year-old male patient with recurrent episodes of free gas in the peritoneal and the retroperitoneal cavities as well as pneumatosis intestinalis 3 months after bilateral lung transplant. Interestingly, despite staged laparotomy within the scope of the first episode, no cause for free gas could be found. In a second episode of symptomatically pneumatosis, a conservative treatment with metro_nidazole was performed successfully. Despite several case reports on patients with pneumatosis intestinalis after lung transplant, an effective treatment strategy has not yet been proposed...
June 5, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28575335/deep-neuromuscular-block-to-optimize-surgical-space-conditions-during-laparoscopic-surgery-a-systematic-review-and-meta-analysis
#19
M H Bruintjes, E V van Helden, A E Braat, A Dahan, G J Scheffer, C J van Laarhoven, M C Warlé
Neuromuscular block (NMB) is frequently used in abdominal surgery to improve surgical conditions by relaxation of the abdominal wall and prevention of sudden muscle contractions. The evidence supporting routine use of deep NMB is still under debate. We aimed to provide evidence for the superiority of routine use of deep NMB during laparoscopic surgery. We performed a systematic review and meta-analysis of studies comparing the influence of deep vs moderate NMB during laparoscopic procedures on surgical space conditions and clinical outcomes...
June 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28571235/effect-of-dexmedetomidine-versus-fentanyl-on-haemodynamic-response-to-patients-undergoing-elective-laparoscopic-surgery-a-double-blinded-randomized-controlled-study
#20
Lovina Neil, Ashok Patel
INTRODUCTION: Dexmedetomidine, an α2 agonist, can be used as an adjuvant in general anaesthesia as it attenuates the stress response to various noxious stimuli and helps in maintaining the perioperative haemodynamic stability along with sedation and not causing any significant respiratory depression in the postoperative period. AIM: To study the difference in haemodynamic responses of dexmedetomidine and fentanyl in patients undergoing laparoscopic surgery. MATERIALS AND METHODS: Sixty patients were divided into two groups of 30 each randomly...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
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