Gases for establishing pneumoperitoneum during laparoscopic abdominal surgery

Cheng, Yao; Lu, Jiong; Xiong, Xian‐Ze; Wu, Sijia; Lin, Yixin; Wu, Taixiang; Cheng, Nan‐Sheng

doi:10.1002/14651858.cd009569.pub2

Cited by 33 publications

(33 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is also associated with tachycardia, cardiac arrhythmias and pulmonary edema. Furthermore, it may cause peritoneal irritation and subsequent postoperative pain, while its use is associated with immunological impairment [10].…”

Section: Discussionmentioning

confidence: 99%

Room air versus carbon dioxide pneumoperitoneum: effects on oxidative state, apoptosis and histology of splanchnic organs

et al. 2015

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Room air versus carbon dioxide pneumoperitoneum: effects on oxidative state, apoptosis and histology of splanchnic organs

et al. 2015

View full text Add to dashboard Cite

show abstract

“…This means that CO 2 gas is readily absorbed and rapidly excreted. Thus the perioperative risks of gas embolism, retained gas, pneumothorax and potentially pain are less with CO 2 insufflation compared to air [5][6][7].…”

Section: Carbon Dioxide (Co 2 ) Pneumoperitoneummentioning

confidence: 99%

Changes in the coelomic microclimate during carbon dioxide laparoscopy: morphological and functional implications

Wilson

2017

Pleura and Peritoneum

View full text Add to dashboard Cite

In this article the adverse effects of laparoscopic CO 2 -pneumoperitoneum and coelomic climate change, and their potential prevention by warmed, humidified carbon dioxide insufflation are reviewed. The use of pressurized cold, dry carbon dioxide (C0 2 ) pneumoperitoneum causes a number of local effects on the peritoneal mesothelium, as well as systemic effects. These can be observed at a macroscopic, microscopic, cellular and metabolic level. Local effects include evaporative cooling, oxidative stress, desiccation of mesothelium, disruption of mesothelial cell junctions and glycocalyx, diminished scavenging of reactive oxygen species, decreased peritoneal blood flow, peritoneal acidosis, peritoneal hypoxia or necrosis, exposure of the basal lamina and extracellular matrix, lymphocyte infiltration, and generation of peritoneal cytokines such as IL-1, IL-6, IL-8 and TNFα. Such damage is increased by high CO 2 insufflation pressures and gas velocities and prolonged laparoscopic procedures. The resulting disruption of the glycocalyx, mesothelial cell barrier and exposure of the extracellular matrix creates a cascade of immunological and proinflammatory events and favours tumour cell implantation. Systemic effects include cardiopulmonary and respiratory changes, hypothermia and acidosis. Such coelomic climate change can be prevented by the use of lower insufflation pressures and preconditioned warm humidified CO 2 . By achieving a more physiological temperature, pressure and humidity, the coelomic microenvironment can be better preserved during pneumoperitoneum. This has the potential clinical benefits of maintaining isothermia and perfusion, reducing postoperative pain, preventing adhesions and inhibiting cancer cell implantation in laparoscopic surgery.

show abstract

“…Carbon dioxide is absorbed by the peritoneum and alters physiologic parameters, which can complicate surgery: mainly changes to the heart and lungs (cardiopulmonary changes). Cheng et al, (2013) performed a meta-analysis of all the studies using other medical gases, nitrous oxide and helium, in creating the pneumoperitoneum required for performing abdominal laparoscopic surgery. Their results concluded that there were fewer cardiopulmonary changes with helium than with carbon dioxide (Cheng et al, 2013).…”

Section: Application Of Helium In Surgerymentioning

confidence: 99%

“…Cheng et al, (2013) performed a meta-analysis of all the studies using other medical gases, nitrous oxide and helium, in creating the pneumoperitoneum required for performing abdominal laparoscopic surgery. Their results concluded that there were fewer cardiopulmonary changes with helium than with carbon dioxide (Cheng et al, 2013). Helium has been found to be a safe alternative as a n insufflant in high-risk patients undergoing laparoscopic renal surgery.…”

Section: Application Of Helium In Surgerymentioning

confidence: 99%