Carbon Dioxide and Helium Insufflation During Laparoscopic Radical Nephrectomy in a Patient With Severe Pulmonary Disease

Wolf, J. Stuart; Clayman, V. Ralph; McDougall, Elspeth M.; Shepherd, David L.; Folger, Walter; Monk, Terri G.

doi:10.1016/s0022-5347(01)66079-8

Cited by 12 publications

(4 citation statements)

References 2 publications

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“…If these measures fail, switching to an alternative insufflant such as helium can be performed. 16,18 Intraoperative oliguria is a well-known, but not completely understood, pressure-dependent phenomenon that results from the pneumoperitoneum. Its cause appears to be multifactorial, involving vascular and parenchymal compression, as well as systemic hormonal effects.…”

Section: Physiologic Complicationsmentioning

confidence: 99%

Complications of Hand-Assisted Laparoscopic Urologic Surgery

Hedican

2004

Journal of Endourology

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Since the first urologic case was reported in 1997, hand-assisted laparoscopic surgery (HALS) has proven to be useful for both the experienced and the inexperienced laparoscopic surgeon. In a recent series of 196 cases at three major medical institutions, 18 patients (9.2%) suffered 32 major complications, and 28 patients (14.3%) had 31 minor complications. The most common major complications were small-bowel injury, requirement for open conversion to control bleeding, and need for reintubation. The most frequent minor complications were urinary retention, splenic capsular injury, and prolonged ileus. The author discusses ways of recognizing and managing the complications of HALS, including physiologic, access-related, intraoperative, and post-operative problems.

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Section: Physiologic Complicationsmentioning

confidence: 99%

Complications of Hand-Assisted Laparoscopic Urologic Surgery

Hedican

2004

Journal of Endourology

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“…In addition, the use of CO 2 is associated with the development of hypercarbia, acidosis, and cardiac arrythmias due to absorption of CO 2 from the peritoneal surface [7]. There are even documented instances where complications arising from CO 2 absorption during laparoscopy created critical situations [9,27,31].…”

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confidence: 99%

Videoscopic surgery under local and regional anesthesia with helium abdominal insufflation

Crabtree

Fishman

1999

Surg Endosc

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Helium gas should be considered the agent of choice for intraperitoneal insufflation in high-risk patients not only because helium avoids the metabolic consequences of CO(2) insufflation but also because it permits selected procedures to be performed under local-regional anesthesia. Helium may be contraindicated for laparoscopic procedures involving extraperitoneal insufflation due to the increased risk for pneumothoraces.

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“…It has already been used with good clinical tolerance during cholecystectomies, or interventions for pheochromocytoma as well as for renal cancers. 17–22 Jacobi et al ., in 1997, proposed the use of helium laparoscopy in order to avoid the hypothetical effects of CO 2 on tumour growth and spread. These authors demonstrated that tumour growth and spread was less favoured by the use of helium laparoscopy than CO 2 laparoscopy.…”

Section: Introductionmentioning

confidence: 99%

No difference found in survival using carbon dioxide laparoscopy, helium laparoscopy, or laparotomy in an adenocarcinoma nude mouse model

Narducci¹,

Lanvin²,

Occelli³

et al. 2000

Gynaecol Endoscopy

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Objective To evaluate the impact of surgical approach on tumour growth and survival of xenografted nude mice. Materials and methods 237 mice which had received 106 SKOV‐3 (human ovarian adenocarcinoma) cells subcutaneously and intraperitoneally, were anaesthetized for 60 min. The animals were randomly allocated to one of four groups: control group (n = 57), laparotomy (n = 61), CO2 laparoscopy (n = 62), or He laparoscopy (n = 57). Results Scar tumour grafts were found in 83.6% in the laparotomy group and in 64.5% in the group which underwent CO2 laparoscopy (P = 0.02). No significant differences were observed between any of the groups in relation to subcutaneous tumour volume at day 30 (P = 0.95), the intraperitoneal tumour volume (P = 0.70), the frequency of peritoneal carcinomatosis (P = 0.55), mesocolic and submesocolic tumour location (P = 0.52) or diaphragmatic metastases (P = 0.97). Moreover, no effect was found on the period of survival of the animals (P = 0.83). The average duration of survival was 63.4 ± 18.2 days (control), 64.2 ± 13.2 (laparotomy), 65.2 ± 16.9 (CO2) and 64.9 ± 16.5 (helium). Conclusion In the model used, CO2 laparoscopy is not associated with increased risk of tumour dissemination, scar implantation or death.

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Carbon Dioxide and Helium Insufflation During Laparoscopic Radical Nephrectomy in a Patient With Severe Pulmonary Disease

Cited by 12 publications

References 2 publications

Complications of Hand-Assisted Laparoscopic Urologic Surgery

Complications of Hand-Assisted Laparoscopic Urologic Surgery

Videoscopic surgery under local and regional anesthesia with helium abdominal insufflation

No difference found in survival using carbon dioxide laparoscopy, helium laparoscopy, or laparotomy in an adenocarcinoma nude mouse model

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