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pneumoperitoneum effects

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https://www.readbyqxmd.com/read/29026353/association-of-body-mass-index-and-postoperative-acute-kidney-injury-in-patients-undergoing-laparoscopic-surgery
#1
Maged Y Argalious, Natalya Makarova, Alexander Leone, Jacek Cywinski, Ehab Farag
BACKGROUND: Whether the deleterious effects of carbon dioxide pneumoperitoneum on the kidneys are exacerbated in the obese population remains unknown. We hypothesized that increased body mass index (BMI) is associated with an increased incidence of postoperative acute kidney injury (AKI) in patients undergoing noncardiac laparoscopic surgery. METHODS: Following institutional review board approval, we analyzed data on 8,543 adult patients with American Society of Anesthesiologists physical status scores of I-IV who had inpatient noncardiac laparoscopic surgery from 2005-2014...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28984093/effects-of-laparoscopic-radical-prostatectomy-on-intraoperative-autonomic-nervous-system-control-of-hemodynamics
#2
Ferdinando Raimondi, Riccardo Colombo, Elena Costantini, Andrea Marchi, Alberto Corona, Tommaso Fossali, Beatrice Borghi, Stefano Figini, Stefano Guzzetti, Alberto Porta
BACKGROUND: Laparoscopic radical prostatectomy induces hemodynamic changes that have been supposed due to autonomic nervous system activity. The aim of this study is to measure the sympathetic and vagal modulation on hemodynamic response to steep Trendelenburg and pneumoperitoneum for laparoscopic surgery. METHODS: Autonomic nervous system modulation was assessed noninvasively through heart rate variability and arterial pressure variability analysis in patients undergoing elective laparoscopic radical prostatectomy and in awake volunteers during head-down tilt...
October 4, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28984091/repeated-alveolar-recruitment-maneuvers-with-and-without-positive-end-expiratory-pressure-during-bariatric-surgery-a-randomized-trial
#3
Ke Wei, Su Min, Jun Cao, Xuechao Hao, Jie Deng
BACKGROUND: Positive end-expiratory pressure (PEEP) is considered essential in protective ventilation, while may lead to hemodynamic impairment. In the present study, we investigated the effect of repeated alveolar recruitment maneuvers (ARMs) with or without additional PEEP on the arterial oxygenation of obese patients who were undergoing bariatric surgery. METHODS: Thirty-six obese adult patients with body mass index (BMI) >40 kg/m2 who were scheduled for laparoscopic sleeve gastrectomy were randomly allocated into three groups: (1) control group, no intraoperative ARMs; (2) ARM+ZEEP group, repeated ARMs every 30 minutes without extra PEEP; or (3) ARM+PEEP group, ARMs followed by 8 cm H2O of PEEP from the onset of pneumoperitoneum...
October 4, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28964926/managing-postoperative-pain-after-minimally-invasive-gynecologic-surgery-in-the-era-of-the-opioid-epidemic
#4
REVIEW
Marron Wong, Stephanie Morris, Karen Wang, Khara Simpson
In this review, we examine the evidence behind non-opioid medication alternatives, peripheral nerve blocks, surgical techniques, and postoperative recovery protocols that can help minimize and effectively treat postoperative pain after minimally invasive gynecologic surgery (MIGS). Due to the depth and heterogeneity of the data, a narrative review was performed of reported interventions. A comprehensive review was performed of Pubmed, EMBASE, and the Cochrane Database with a focus on randomized controlled trials (RCT)...
September 27, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28958611/clevidipine-for-hypertension-treatment-in-pheochromocytoma-surgery
#5
C Luis-García, E Arbonés-Aran, C Teixell-Aleu, L Lorente-Poch, L Trillo-Urrutia
Pheochromocytoma is a catecholamine-producing tumour and laparoscopic adrenalectomy is its treatment of choice. During pneumoperitoneum insufflation and tumour handling there is a high risk of massive catecholamine release and hypertensive crisis. After tumour excision, severe arterial hypotension is a common effect, due to relative vasodilation and the residual effect of antihypertensive drugs. We report the case of a patient with pheochromocytoma who was treated with laparoscopic adrenalectomy. During surgical manipulation there was a sudden hypertensive peak that could be controlled quickly with clevidipine infusion...
September 25, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28952820/a-novel-laparoscopic-surgery-model-with-a-device-to-expand-the-abdominal-working-space-in-rats-the-influence-of-pneumoperitoneum-and-skin-incision-length-on-postoperative-inflammatory-cytokines
#6
Naruhiko Murase, Takahisa Tainaka, Hiroo Uchida, Akinari Hinoki, Chiyoe Shirota, Kazuki Yokota, Kazuo Oshima, Ryo Shirotsuki, Kosuke Chiba, Yujiro Tanaka
PURPOSE: Experimental models of laparoscopic surgery generally use large animals owing to a sufficient abdominal working space. We developed a novel laparoscopic surgery model in rats. We performed intestinal anastomosis to demonstrate the feasibility and reliability of this model. MATERIALS AND METHODS: We designed a device for rats that expanded the abdominal working space and allowed us to manipulate the intraperitoneal organs by hand under direct vision with pneumoperitoneum...
September 27, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28928580/preemptive-analgesia-by-intraperitoneal-instillation-of-ropivacaine-in-laparoscopic-cholecystectomy
#7
Tripat Kaur Bindra, Parmod Kumar, Parul Rani, Ashwani Kumar, Hardeep Bariar
BACKGROUND: Preemptive analgesia has the potential to be more effective than a similar analgesic treatment initiated after surgery as it reduces immediate postoperative pain as well as chronic pain. AIM: To study the efficacy of preemptive analgesia with intraperitoneal instillation of ropivacaine in laparoscopic cholecystectomy (LC). MATERIALS AND METHODS: This prospective randomized double-blind study was conducted on patients undergoing LC...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28918894/effect-of-pneumoperitoneum-and-patient-positioning-on-intracranial-pressures-during-laparoscopy-a-prospective-comparative-study
#8
Nishant Sahay, Shalini Sharma, Umesh K Bhadani, Akhilesh Singh, Chandni Sinha, Anubha Sahay, Alok Ranjan, Mukta Agarwal
STUDY OBJECTIVE: To evaluate the effect of pneumoperitoneum and head position during laparoscopic surgery on intracranial pressures (ICPs) using sonographic measurements of optic nerve sheath diameter (ONSD). DESIGN: Prospective observational study (Canadian Task Force Classification of Study Design II-1). SETTING: A tertiary level hospital. PATIENTS: Sixty-one female patients ages 15 to 50 years with American Society of Anesthesiologists Grade 1 risk and body mass index ≤ 29 kg/m(2) were admitted to the hospital between November 2015 and October 2016 for elective laparoscopic surgery and included in this study...
September 12, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28900123/effects-of-low-intraperitoneal-pressure-and-a-warmed-humidified-carbon-dioxide-gas-in-laparoscopic-surgery-a-randomized-clinical-trial
#9
Sachiko Matsuzaki, Lise Vernis, Martine Bonnin, Celine Houlle, Aurelie Fournet-Fayard, Giuseppe Rosano, Anne Laure Lafaye, Christian Chartier, Agnes Barriere, Brigitte Storme, Jean-Etienne Bazin, Michel Canis, Revaz Botchorishvili
Laparoscopic surgery technology continues to advance. However, much less attention has been focused on how alteration of the laparoscopic surgical environment might improve clinical outcomes. We conducted a randomized, 2 × 2 factorial trial to evaluate whether low intraperitoneal pressure (IPP) (8 mmHg) and/or warmed, humidified CO2 (WH) gas are better for minimizing the adverse impact of a CO2 pneumoperitoneum on the peritoneal environment during laparoscopic surgery and for improving clinical outcomes compared to the standard IPP (12 mmHg) and/or cool and dry CO2 (CD) gas...
September 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28888803/effects-of-pneumoperitoneum-and-of-an-alveolar-recruitment-maneuver-followed-by-positive-end-expiratory-pressure-on-cardiopulmonary-function-in-sheep-anesthetized-with-isoflurane-fentanyl
#10
Jéssica C Rodrigues, Francisco J Teixeira-Neto, Sofia A Cerejo, Nathalia Celeita-Rodríguez, Natache A Garofalo, Juliany G Quitzan, Thalita L A Rocha
OBJECTIVE: To investigate the effects of pneumoperitoneum alone or combined with an alveolar recruitment maneuver (ARM) followed by positive end-expiratory pressure (PEEP) on cardiopulmonary function in sheep. STUDY DESIGN: Prospective, randomized, crossover study. ANIMALS: A total of nine adult sheep (36-52 kg). METHODS: Sheep were administered three treatments (≥10-day intervals) during isoflurane-fentanyl anesthesia and volume-controlled ventilation (tidal volume: 12 mL kg(-1)) with oxygen: CONTROL (no intervention); PNEUMO (120 minutes of CO2 pneumoperitoneum); PNEUMOARM/PEEP (PNEUMO protocol with an ARM instituted after 60 minutes of pneumoperitoneum)...
June 7, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28870760/endoscopic-management-of-erosion-after-banded-bariatric-procedures
#11
Matthew D Spann, Chetan V Aher, Wayne J English, D Brandon Williams
BACKGROUND: Prosthetic materials wrapped around a portion of the stomach have been used to provide gastric restriction in bariatric surgery for many years. Intraluminal erosion of adjustable and nonadjustable gastric bands typically occurs many years after placement and results in various symptoms. Endoscopic management of gastric band erosion has been described and allows for optimal patient outcomes. OBJECTIVES: We will describe our methods and experience with endoscopic management of intraluminal gastric band erosions after bariatric procedures...
July 24, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28836494/fibrillar-collagen-injection-for-organ-protection-during-thermal-ablation-of-hepatic-malignancies
#12
Bill S Majdalany, Jonathan Willatt, Jeffrey Forris Beecham Chick, Ravi N Srinivasa, Wael A Saad
Percutaneous image-guided ablation is performed throughout many areas of the body for various pathologies including hepatic malignancies. Heat and cold-based ablative technologies are effective and well-tolerated with an acceptable safety profile. However, ablative therapies may be technically more challenging and cause collateral thermal injury if the targeted lesion is adjacent to critical organs. Previously, techniques including artificial ascites and pneumoperitoneum have been utilized to displace or insulate critical structures from the ablation zone...
September 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28802605/laparoscopic-cholecystectomy-under-neuraxial-anesthesia-compared-with-general-anesthesia-systematic-review-and-meta-analyses
#13
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
#14
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
#15
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
#16
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...
October 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
#17
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
#18
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
#19
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
#20
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
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