Postoperative morbidity following gynaecological outpatient Iaparoscopy. A reappraisal of the service

Collins, K.M.; Docherty, Philip; Plantevin, O.M.

doi:10.1111/j.1365-2044.1983.tb06534.x

Cited by 13 publications

(16 citation statements)

References 11 publications

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“…Pain after laparoscopy does not seem to be related to the volume of gas used during the operation. We use a relatively large volume but pain was less frequent than reported by others (Collins et al 1984), possibly due to our usual practice of compressing the abdomen manually to expel excess gas through the open laparoscopy cannula at the end of the operation. The further marked benefit of a gas drain postoperatively suggests that visceral peristaltic and voluntary muscle activity leads to expulsion of a further considerable volume.…”

Section: Discussionmentioning

confidence: 82%

Abdominal pain after laparoscopy: the value of a gas drain

Alexander

Hull

1987

BJOG

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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.

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Section: Discussionmentioning

confidence: 82%

Abdominal pain after laparoscopy: the value of a gas drain

Alexander

Hull

1987

BJOG

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“…The pain usually reaches its maximum 24 hours postoperatively before it declines gradually.1 This shoulder pain was found to be similar to, but less severe than, that produced when using suxamethonium in anesthesia. 1 Following the introduction of laparoscopic surgery, shoulder pain was reported in randomized studies to be more common than after laparotomy incisions.19 An incidence as high as 42% was reported.20 In retrospective studies, however, it was either not reported2-5 or reported as a rarity, with figures as low as 0.8%6,21 Residual CO2 in the pneumoperitoneum was blamed for the pain. The gas is thought to act either by its irritant effect on the peritoneum and phrenic nerve.1,8-10 or by creating a space between the liver and the diaphragm, leading to loss of the suction effect on the liver by the diaphragm with increased traction on the triangular and coronary ligaments.11,12,22 However, the results coming from different studies regarding the role of residual CO2 are controversial.…”

Section: Resultsmentioning

confidence: 99%

Bupivacaine Instillation into Gallbladder Bed after Laparoscopic Cholecystectomy: Does It Decrease Shoulder Pain?

Gharaibeh

Al‐Jaberi²

2000

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…The nausea, vomiting, and/or retching is a source of significant discomfort following laparoscopic cholecystectomy, and patients with significant gastrointestinal dysfunction should usually be admitted to the hospital for observation and comfort [7,15,23,29,34]. Only two of our patients required readmission for nausea, vomiting, and dehydration, with no significant sequelae.…”

Section: Case #/--Patient Ehmentioning

confidence: 96%

Is outpatient laparoscopic cholecystectomy wise?

1995

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The authors report a prospective analysis of their experience with 506 consecutive laparoscopic cholecystectomies to examine the appropriateness of outpatient or same-day laparoscopic cholecystectomy. Thirty-eight patients experienced at least one postoperative complication. The complication was clinically evident or suspected in only 4 of these 38 patients within 8 h following surgery. Thirty-nine percent and 76% of complications were clinically detected at 24 and 48 h, respectively. Nausea and vomiting occurred among 32% of all patients on the day of operation and extended into the 1st postoperative day in 10%. Compared to predicted values, forced vital capacity was 61 +/- 5% 1 h postoperatively in 32 patients studied. At 6 and 24 h postoperatively, forced vital capacity was 63 +/- 7% and 66% respectively. Postoperative analgesic medication requirement was determined in 220 patients who were provided with a patient-controlled intravenous morphine analgesia machine with no basal rate. Consumption of morphine was highly variable but substantial on the day of operation: 17 +/- 16 mg. Most complications of laparoscopic cholecystectomy, including life-threatening complications, are not apparent by 8 h postoperatively and may not be apparent at 24 h. The potential for delay in the diagnosis and treatment of complications, variable but substantial analgesic requirements, impaired postoperative ventilation, and postoperative gastrointestinal dysfunction argue for the need to use great caution in selecting patients for outpatient laparoscopic cholecystectomy. Criteria are proposed to identify patients who are safest for outpatient laparoscopic cholecystectomy.

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Postoperative morbidity following gynaecological outpatient Iaparoscopy. A reappraisal of the service

Abstract: Summary Fifty‐six women having out‐patient gynaecological laparoscopies were studied to determine anasthetic problems and postoperative morbidity. It is concluded that the procedure is safe, and although the postoperative morbidity appears high it is very acceptable to the patient.

Cited by 13 publications

References 11 publications

Abdominal pain after laparoscopy: the value of a gas drain

Abdominal pain after laparoscopy: the value of a gas drain

Bupivacaine Instillation into Gallbladder Bed after Laparoscopic Cholecystectomy: Does It Decrease Shoulder Pain?

Is outpatient laparoscopic cholecystectomy wise?

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