A Novel Strategy of Laparoscopic Insufflation Rate Improving Shoulder Pain: Prospective Randomized Study

Hsu, Kuo–Feng; Chen, Cheng‐Jueng; Yu, Jyh‐Cherng; Wu, Seng-Tang; Chen, Bao-Chung; Yang, Chih‐Wei; Chen, Teng-Wei; Hsieh, Chung-Bao; Chan, De-Chuan

doi:10.1007/s11605-018-3896-5

Cited by 8 publications

(10 citation statements)

References 25 publications

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“…This strategy can reduce the severity of shoulder pain, compared with continuous high-ow rate insu ation in laparoscopic cholecystectomy. [7] There was no signi cant difference in the incidence and severity of shoulder pain between groups. However, the analgesic agents, which were routinely prescribed after surgery, may shade the real effects of VTS on shoulder pain.…”

Section: Discussionmentioning

confidence: 83%

“…Both groups received the insu ation strategy of low ow rate to induce pneumoperitoneum followed by high-ow rate to maintain the pressure at 12 mmHg. [7] Energy devices such as monopolar cautery and LigaSure were used intraoperatively for bleeding control and dissection. After the surgery was completed, the trocars were removed to release intra-abdominal CO 2 and the abdomen was compressed by surgeons to evacuate the residual gas.…”

Section: Surgical Techniquesmentioning

confidence: 99%

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Comparing Clinical Impacts Between Valveless Trocar System and Standard Insufflation in Bariatric Surgery

Hsu

Lin

Feng

et al. 2021

Preprint

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Purpose In laparoscopic surgery, higher intra-abdominal pressure is needed to achieve a well-exposed surgical field in obese patients, which may results in undesirable effects on cardiopulmonary systems. The AirSeal Intelligent Flow System™ provides stable pneumoperitoneum and constant smoke evacuation. However, studies regarding VTS in bariatric surgery are rare. This study aimed to investigate the effects of VTS on laparoscopic bariatric surgery. Methods We conducted a retrospective study using our prospective database. Sixty patients were enrolled equally to the VTS group and standard insufflation device group. Patient characteristics, intraoperative and postoperative data were analyzed. The Visual Analog Scale (scores: 0–10) was applied to measure the intensity of shoulder pain at 1, 12, 24, and 48 h after surgery, and surgeon’s satisfaction on the surgical field visualization was assessed using a numerical rating scale of 0 (not adequate) to 10 (optimal). Results There was no significant difference in bradycardia during insufflation, operative time, blood loss, shoulder pain, and complications as well as shoulder pain between groups. VTS group showed a significant higher scores of surgical field visualization. Conclusions There was no significant difference in most perioperative and postoperative outcomes; however, VTS group achieved a better surgical field visualization for surgeons.

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Section: Discussionmentioning

confidence: 83%

Section: Surgical Techniquesmentioning

confidence: 99%

Comparing Clinical Impacts Between Valveless Trocar System and Standard Insufflation in Bariatric Surgery

Hsu

Lin

Feng

et al. 2021

Preprint

Self Cite

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“…With this, some authors have tried to decrease shoulder pain in patients with suction drains or low flow rates to induce pneumoperitoneum followed by high flow rates. [3][4][5] Many surgeons neglect to remove free residual gas because the shoulder pain it causes tends to resolve spontaneously within several days. Some patients who undergo laparoscopy complain that they have more shoulder pain than operative wound pain, and this pain may decrease a patient's satisfaction with the procedure.…”

Section: Introductionmentioning

confidence: 99%

“…With this, some authors have tried to decrease shoulder pain in patients with suction drains or low flow rates to induce pneumoperitoneum followed by high flow rates. [ 3 – 5 ]…”

Section: Introductionmentioning

confidence: 99%

Residual intraperitoneal carbon dioxide gas following laparoscopy for adnexal masses: Residual gas volume assessment and postoperative outcome analysis

2022

Medicine

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Free residual gas after laparoscopy may cause shoulder pain, decreasing patient satisfaction with the procedure. We analyzed the correlation between postoperative residual carbon dioxide gas and shoulder pain, explored the peri-and postoperative factors associated with residual carbon dioxide and determined the effects of the use of a drainage tube. A cohort of 326 patients who underwent laparoscopic adnexal surgery between March 2005 and June 2018 at a teaching hospital in Korea was retrospectively analyzed through a medical records review. The enrolled patients were divided into 1-, 2-, and 3-port groups. The right volume, left volume, and total volume of residual gas were calculated using a formula based on measurements obtained from chest X-rays. Continuous variables were compared using Student t tests. Categorical variables were compared with the chi-square test or Kruskal-Wallis test. The total volumes of postoperative residual carbon dioxide gas were significantly different between the 1and 2-port groups and between the 1-and 3-port groups (157.3 ± 179.2 vs 25.1 ± 92.3 mL and 157.3 ± 179.2 vs 12.9 ± 36.4 mL, respectively). The volume of residual gas and the time to the first passage of gas were positively correlated. The total volume of residual gas was more strongly correlated with the operative wound pain score than with the shoulder pain score. Additionally, the pre-and postoperative white blood cell counts, postoperative hospitalization duration, residual carbon dioxide volume, and shoulder pain score were significantly different between patients with and without a drainage tube. Although the volume of residual gas was not correlated with the shoulder pain score, the author found that both were lower in patients with a drainage tube than in those without, indicating that a drainage tube could be safely used to decrease residual gas volume and the shoulder pain score without increasing the risk of postoperative infection. Abbreviations: BMI = body mass index, Hb = hemoglobin, VRS = verbal rating scale, WBC = white blood cell.

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“…Previous papers have shown that chemical, physical, and biological features of pneumoperitoneum might affect clinical outcomes, such as postoperative pain, length of stay, and recovery time [13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

The “Dark Side” of Pneumoperitoneum and Laparoscopy

Umano

Delehaye

Noviello

et al. 2021

Minimally Invasive Surgery

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Laparoscopic surgery has been one of the most common procedures for abdominal surgery at pediatric age during the last few decades as it has several advantages compared to laparotomy, such as shorter hospital stays, less pain, and better cosmetic results. However, it is associated with both local and systemic modifications. Recent evidence demonstrated that carbon dioxide pneumoperitoneum might be modulated in terms of pressure, duration, temperature, and humidity to mitigate and modulate these changes. The aim of this study is to review the current knowledge about animal and human models investigating pneumoperitoneum-related biological and histological impairment. In particular, pneumoperitoneum is associated with local and systemic inflammation, acidosis, oxidative stress, mesothelium lining abnormalities, and adhesion development. Animal studies reported that an increase in pressure and time and a decrease in humidity and temperature might enhance the rate of comorbidities. However, to date, few studies were conducted on humans; therefore, this research field should be further investigated to confirm in experimental models and humans how to improve laparoscopic procedures in the spirit of minimally invasive surgeries.

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A Novel Strategy of Laparoscopic Insufflation Rate Improving Shoulder Pain: Prospective Randomized Study

Cited by 8 publications

References 25 publications

Comparing Clinical Impacts Between Valveless Trocar System and Standard Insufflation in Bariatric Surgery

Comparing Clinical Impacts Between Valveless Trocar System and Standard Insufflation in Bariatric Surgery

Residual intraperitoneal carbon dioxide gas following laparoscopy for adnexal masses: Residual gas volume assessment and postoperative outcome analysis

The “Dark Side” of Pneumoperitoneum and Laparoscopy

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