Fast-track management of pneumothorax in laparoscopic surgery

Raveendran, Raviraj; Prabu, Hari Narayana; Ninan, Sarah; Darmalingam, Sathish

doi:10.4103/0019-5049.76564

Cited by 6 publications

(5 citation statements)

References 3 publications

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“…The incidence of pneumothorax ranges from 0.01 to 0.4% based on surgical procedure and patient comorbidities [ 2 ]. A capnothorax is a type of pneumothorax specifically from CO 2 used for insufflation during laparoscopic procedures.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Capnothorax during Robotic Diaphragmatic Endometriosis Excision

Dunn

Misra

2022

Case Reports in Anesthesiology

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Laparoscopic surgery is performed quite commonly and is known to have numerous advantages over traditional open surgery. Albeit rare, there are life-threatening complications as a result of laparoscopic surgery including those associated with the cardiopulmonary system. In our case, we present hemodynamically unstable capnothorax that occurred during robotic diaphragmatic endometriosis excision which was treated conservatively. It is critical for anesthesia providers to recognize when capnothorax occurs and to understand the implications and treatment in order to minimize unnecessary procedures and morbidity associated with such.

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Section: Discussionmentioning

confidence: 99%

Intraoperative Capnothorax during Robotic Diaphragmatic Endometriosis Excision

Dunn

Misra

2022

Case Reports in Anesthesiology

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“…Unlike the pneumothorax caused by creation of bronchopleural conduit due to barotrauma, in the event of pneumothorax caused by CO 2 the use of positive end-expiratory pressure (PEEP) can be helpful. 3,4 Although most cases can be managed conservatively, capnothorax can be a life-threatening situation. Anesthesiologists should be aware of this complication because successful management depends on early recognition and treatment.…”

Section: Introductionmentioning

confidence: 99%

Capnothorax During Laparoscopy in Trendelenburg Position: A Rare Case Study

Damas¹,

Gonçalves²,

Antunes³

et al. 2020

Acta Med Port

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Pneumothorax is an infrequent complication of laparoscopic surgery. Most cases occur during upper abdominal surgery, since a head-down position (Trendelenburg) pushes the liver and peritoneum against the diaphragm, reducing gas release. When it is due to CO2 diffusion across congenital diaphragmatic defects, it usually resolves itself spontaneously after de-insufflation of the pneumoperitoneum. Increasing positive end-expiratory pressure to counteract intra-abdominal pressure is an effective measure when a pulmonary origin is excluded. We report a case of right-sided hypertensive capnothorax due to a diaphragmatic defect, during lower abdominal surgery, which was successfully managed without the need for chest drainage. This case highlights the importance of maintaining active vigilance and a high index of suspicion for pneumothorax during laparoscopic surgery.

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“…[ 6 ] Pneumothorax is often diagnosed in a patient with subcutaneous or mediastinal emphysema, oxygen desaturation, circulatory disturbance, or MV impairment with increase of peak pressure. [ 1 3 4 ] However, it is likely to go unnoticed post-operatively in a sedated, pain-free patient receiving supplemental oxygen, as in this case. Several risk factors were found in the reported patient including, heavy smoking, bullous emphysema, neck surgery, tracheotomy, MV and using of N 2 O.…”

mentioning

confidence: 96%

“…[ 3 ] Carbon dioxide pneumothoraces have been reported during laparoscopic surgery. [ 4 ] N 2 O has been known for a long time to diffuse into body cavities increasing the volume of pneumothorax. [ 5 ] In patients with bullous emphysema, N 2 O may increase the volume of bullae increasing the risk of rupture.…”

mentioning

confidence: 99%