Abdominal pain after laparoscopy: the value of a gas drain

Abstract

In an attempt to reduce pain after laparoscopy, a drain was left for 6 h in the peritoneal cavity through the umbilical incision to take advantage of visceral peristaltic and voluntary muscle movements to expel residual gas. In a randomized study 25 treated patients were compared with 28 controls. Use of the drain was found to approximately halve the frequency of pain throughout the first 2 postoperative days. The severity of pain was also significantly reduced in the first 6 h and after mobilization at home the next day when pain is usually at its worst.

Maneuvers to Decrease Laparoscopy-Induced Shoulder and Upper Abdominal Pain

“…34 This result was similar to that of laparoscopic cholecystectomy and gynecologic laparoscopic surgery. 35,36 It suggests that mobilization increases traction on the peritoneal reflections of the heavy viscera, which then lose suction support for their weight owing to the creation of peritoneal spaces by the carbon dioxide.…”

A comparative study to evaluate the outcome of routine use of drain verses no drain after laparoscopic cholecystectomy: a tertiary care teaching centre experience

“…9 Carbonic acid that results from CO 2 insufflations and gas that separates the liver dome the diaphragm causing the stretch of the attachments of the liver result in the postoperative pain, especially shoulder tip pain. 16 Nursal et al found subdiaphragmatic drain effective in reducing the incidence and the amount of subdiaphragmatic gas bubble. 15 Another study in which residual gas was removed by active aspiration through the trocars rather than drains documented a decrease in opioid use, but not in VAS scores.…”

A randomized prospective study of single-port and four-port approaches for hysterectomy in terms of postoperative pain

“…Etiologic factors associated with postoperative pain include neuropraxia of the phrenic nerves due to pneumoperitoneum, the type of insufflated gas, residual pneumoperitoneum, operative wound pain, direct tissue trauma from electrocoagulation and mechanical injury, and sociocultural and individual factors [16][17][18][19]. The current study was designed as a randomized prospective study at a single institution, and TLH was performed in the same manner in the two study groups.…”