Evidence of Venous Stasis After Abdominal Insufflation for Laparoscopic Cholecystectomy

Beebe, David S.; McNevin, M P; Belani, Kumar G.; Letourneau, J G; Crai, N.; Goodale, Robert L.

doi:10.1097/00000542-199209001-00148

Cited by 74 publications

(82 citation statements)

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“…The second trimester is considered the safest period to perform any surgery [25] because the uterus, due to its small volume, is less susceptible to traumatic injuries. But recently, some studies [26][27][28][29][30][31][32][33][34] have demonstrated that selected laparoscopic procedures can be performed safely during pregnancy even in the third trimester. Complications such as fetal loss and premature labor do occur, but can be kept around 5% in the second trimester with the use of appropriate techniques.…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic management of appendicitis and symptomatic cholelithiasis during pregnancy

Halkic

Tempia-Caliera

Ksontini

et al. 2006

Langenbecks Arch Surg

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Background Laparoscopic surgery during pregnancy is a challenging procedure that most surgeons are reluctant to perform. The objective of this study was to evaluate whether laparoscopic appendectomy and cholecystectomy is safe in pregnant women. The management of these situations remains controversial. We report a single center study describing the successful management of 16 patients during pregnancy. Methods More than 3,356 laparoscopic procedures were performed in our institutions between May 1990 and June 2005. Sixteen of these patients were operated on in the second and third trimester between 22 and 32 weeks of estimated gestational age. We performed 11 laparoscopic appendectomies and 5 laparoscopic cholecystectomies. We also reviewed the management and operative technique used in these patients. Results In this study, the laparoscopic appendectomy or cholecystectomy was performed successfully in all patients. Three patients were in their second trimester, weeks 22, 23, and 25, and 13 were in the third trimester, weeks 27 (three patients), 28 (five patients), 31 (three patients), and 32 (two patients). No maternal or fetal morbidity occurred. Open laparoscopy was performed safely in all patients and all patients delivered healthy babies.Conclusion From our experience laparoscopic management of appendicitis and biliary colic during pregnancy is safe, however the second trimester is preferable for laparoscopic cholecystectomy. Pregnancy is not a contraindication to the laparoscopic approach to appendicitis or symptomatic cholelithiasis. We believe that laparoscopic operations, when performed by experienced surgeons, are safe and even preferable for the mother and the fetus.

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Section: Resultsmentioning

confidence: 99%

Laparoscopic management of appendicitis and symptomatic cholelithiasis during pregnancy

Halkic

Tempia-Caliera

Ksontini

et al. 2006

Langenbecks Arch Surg

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“…There are various haemodynamic, respiratory, and stress response changes in laparoscopic surgery due to creation of pneumoperitoneum. [7][8][9][10] In balanced anaesthesia, ideal opioid would permit rapid titration to the effect, successfully prevent unwanted responses to various stimuli, require little supplementation, does not depress cardiovascular function, permit the return of adequate spontaneous ventilation in timely manner and produce residual if not complete post-operative analgesia with minimal side effects. Both the group of drugs have haemodynamic stability, analgesia, sedation and decreases the requirement of other anesthetic drugs and is available at low cost.…”

Section: Discussionmentioning

confidence: 99%

Comparison of butorphanol and fentanyl for balanced anaesthesia in patients undergoing laparoscopic surgeries under general anaesthesia:A prospective, randomized and double-blind study

Mh¹,

Satyanarayana²,

Srinivas³

et al. 2013

JCSR

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INTRODUCTIONPain is an unpleasant sensation, which produces a reaction consisting of withdrawal response, metabolic response, hormonal response and conscious aversion. The side-effects of pain include peripheral vasoconstriction, reduced functional residual capacity and reduced sputum clearance.1,2 Pain relief has many advantages, namely, reduction in metabolic response to trauma, there by prevent postoperative negative nitrogen balance. Moreover pain-free patients have better mobility with immediate benefits in reduced incidence of chest infections and deep vein thrombosis. Laparoscopy has been promoted aggressively and has advantages like shorter hospital stay, more rapid return to normal activities, less pain associated with the small, limited incisions and less postoperative ileus compared with the open laparotomy technique.3,4 Pneumoperitoneum causes various cardiovascular and respiratory derangements. The purpose of this study was to compare equipotent moderate doses of two different analgesics i.e., butorphanol and fentanyl in healthy adult patients undergoing laparoscopic cholecystectomy and appendicectomy under general anaesthesia in terms of intra-operative haemodynamics and post-operative pain relief. MATERIAL AND METHODSThis prospective, randomized and double-blind study was conducted after obtaining approval from the Institutional Ethical Committee to compare the analgesic efficacy of equipotent moderate doses of butorphanol and fentanyl in patients undergoing laparoscopic surgeries under general anaesthesia. ABSTRACTBack ground: Laparoscopic surgeries have advantages like shorter stay and rapid return to normal activities because of small incision and les pain. Pain is an unpleasant sensation in the post-operative period. Methods: Fifty patients of American society Anesthesiologists (ASA) grade I and II, scheduled to undergo laparoscopic surgery, were randomized into butorphanol group (Group B) (n=25) and fentanyl group (Group F) (n=25). Four minutes before induction of anesthesia, Group B received inj. butorphanol 40 µg/Kg intravenously while Group F received Inj. fentanyl 2 µg/kg intravenously. All patients received general anaesthesia with controlled ventilation. Heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), end tidal carbon dioxide (ETCO 2 ), and oxygen saturation were monitored at different intervals. Results: The demographic data was comparable in both groups (p<0.05). There was a significant difference between the two groups in pulse rate after 12 minutes after intubation that persisted till the 2 nd hour of post-operative period. There was no significant difference in DBP till 9 min after intubation, and then onwards significant changes were noted till 4 th hour of post-operative period. Butorphanol provided prolonged analgesia when compared to fentanyl. Conclusions: We conclude that butorphanol is a better alternative to fentanyl for use as analgesic in laparoscopic surgeries because of its ability to produce prolonged analgesia, and less post-operative compli...

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“…Although there are many experimental studies performed on animal models, the infl uence of different pneumoperitoneum pressures on patients' blood gases, respiratory, and venous systems is not clear and some effects of pneumoperitoneum on human body still remains controversial. [1][2][3][4][5][6][7][8][9][10] Intraoperative venous stasis may increase the risk for preoperative or postoperative deep vein thrombosis and pulmonary embolism, especially during laparoscopic procedures. [8,[11][12][13][14][15] Some authors favor venous thromboembolism (VTE) prophylaxis, whereas some not.…”

Section: Introductionmentioning

confidence: 99%

The effects of pneumoperitoneum pressure on blood gases, respiratory and venous systems during laparoscopic cholecystectomy: A prospective randomized trial

Aksakal¹

2017

Laparosc Endosc Surg Sci

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Evidence of Venous Stasis After Abdominal Insufflation for Laparoscopic Cholecystectomy

Cited by 74 publications

References 0 publications

Laparoscopic management of appendicitis and symptomatic cholelithiasis during pregnancy

Laparoscopic management of appendicitis and symptomatic cholelithiasis during pregnancy

Comparison of butorphanol and fentanyl for balanced anaesthesia in patients undergoing laparoscopic surgeries under general anaesthesia:A prospective, randomized and double-blind study

The effects of pneumoperitoneum pressure on blood gases, respiratory and venous systems during laparoscopic cholecystectomy: A prospective randomized trial

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