Gases for establishing pneumoperitoneum during laparoscopic abdominal surgery

Yang, Xudong; Cheng, Yao; Cheng, Nan‐Sheng; Gong, Jie; Bai, Lan; Zhao, Longshuan; Deng, Yong

doi:10.1002/14651858.cd009569.pub4

Cited by 10 publications

(4 citation statements)

References 62 publications

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“…Helium, argon and nitrogen are not GHGs and do not contribute to global warming. However, there is a lack of conclusive evidence on the safety of the use of those gases for abdominal insufflation and still requires further research[ 36 ].…”

Section: Impact Of Mis On Carbon Footprintsmentioning

confidence: 99%

Carbon footprints in minimally invasive surgery: Good patient outcomes, but costly for the environment

Chan¹,

Lo²,

Shelat³

2023

World J Gastrointest Surg

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Obstructive jaundice (OJ) is a common problem in daily clinical practice. However, completely understanding the pathophysiological changes in OJ remains a challenge for planning current and future management. The effects of OJ are widespread, affecting the biliary tree, hepatic cells, liver function, and causing systemic complications. The lack of bile in the intestine, destruction of the intestinal mucosal barrier, and increased absorption of endotoxins can lead to endotoxemia, production of proinflammatory cytokines, and induce systemic inflammatory response syndrome, ultimately leading to multiple organ dysfunction syndrome. Proper management of OJ includes adequate water supply and electrolyte replacement, nutritional support, preventive antibiotics, pain relief, and itching relief. The surgical treatment of OJ depends on the cause, location, and severity of the obstruction. Biliary drainage, surgery, and endoscopic intervention are potential treatment options depending on the patient's condition. In addition to modern medical treatments, Traditional Chinese medicine may offer therapeutic benefits for OJ. A comprehensive search was conducted on PubMed for relevant articles published up to August 1970. This review discusses in detail the pathophysiological changes associated with OJ and presents effective strategies for managing the condition.

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Section: Impact Of Mis On Carbon Footprintsmentioning

confidence: 99%

Carbon footprints in minimally invasive surgery: Good patient outcomes, but costly for the environment

Chan¹,

Lo²,

Shelat³

2023

World J Gastrointest Surg

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“…Prior experimentation to find alternatives to CO 2 include helium (He), nitrous oxide (N 2 O) and oxygen (O 2 ), and systematic reviews have covered the clinical outcomes of these studies, [ 8 ] with concerns about the safety and efficacy of other single-gas type mediums still apparent. However, no reviews at the time of writing have covered the use of gas mixtures to form the insufflation medium and currently, the use of gas mixtures is under-recognised with most topic-relevant studies centred on animal experimentation; only a handful of human studies have been completed.…”

Section: Introductionmentioning

confidence: 99%

Use of mixed gas pneumoperitoneum during minimally invasive surgery: a systematic review of human and mouse modelled laparoscopic interventions

Chen,

Dasgupta,

Vasdev

2024

J Robotic Surg

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The formation of pneumoperitoneum involves the process of inflating the peritoneal cavity during laparoscopic and typically uses CO2 as the insufflation gas. This review aims to identify ideal gas mixtures for establishing the pneumoperitoneum with animal and human studies undertaken up to the writing of this review. A systematic search of PubMed, OVID, and clinicaltrials.gov was performed to identify studies on the utilisation of mixed gases in laparoscopic surgery, including non-randomised/randomised trials, animal and human studies, and studies with inflating pressures between 12 and 16 mmHg. ROBINS-I and RoB2 tool was used to assess the risk of bias. A narrative synthesis of results was performed due to the heterogeneity of the studies. 5 studies from the database search and 5 studies from citation search comprising 128 animal subjects and 61 human patients were found. These studies collated results based on adhesion formation (6 studies), pain scores (2 studies) and other outcomes, with results favouring the use of carbon dioxide + 10% nitrous oxide + 4% oxygen. This has shown a significant reduction in adhesion formation, pain scores and inflammation. The use of this gas mixture provides promising results for future practice. Several of the studies available require larger sample sizes to develop a more definitive answer on the effects of different gas mixtures. Furthermore, the number of confounding factors in randomised trials should be reduced so that each component of the current suggested gas mixture can be tested for safety and efficacy.

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“…The rst step in conventional laparoscopic surgery is to establish a pneumoperitoneum to facilitate adequate working and observation space [14] . CO 2 absorption leads to hypercapnia acidosis postoperative pain, and is also associated with various cardiopulmonary complications such as tachycardia, arrhythmias, and pulmonary oedema [15] . Gasless laparoscopic surgery can avoid related problems, and it has a better performance in operation time and hospital stay.…”

Section: Introductionmentioning

confidence: 99%

Gasless vNOTES vs traditional vNOTES for benign gynecological disease: a randomized controlled clinical trial

Wang,

Liu,

Gong

et al. 2024

Preprint

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Background: Gasless transvaginal natural orifice transluminal endoscopic surgery (G-vNOTES) can avoid complications related to pneumoperitoneum, but there is limited research on G-vNOTES. Here, we aimed to compare the hemodynamic profiles and outcomes of G-vNOTES with traditional vNOTES in the treatment of patients with benign gynecologic disease. Methods: A total of 120 patients with benign gynecologic disease were randomly assigned to G-vNOTES (n=60) or traditional vNOTES (n=60). The primary outcome was vital sign at different time points. Secondary outcomes included conversion rate, surgical time, anesthesia time, the usage of anesthetics, estimated intraoperative blood loss, visual analogue scale (VAS) score for abdominal and shoulder pain and postoperative nausea and vomiting (PONV) at 2 and 24 hours, intraoperative and postoperative complications, time to first anal exhaust, eating, and getting out of bed after surgery, and length of postoperative hospital stay. Results: There was no significant difference between the two groups at the baseline level. The results of the multi-level model indicate that the PetCO2 of the G-vNOTE group is lower than that of the T-vNOTES group (p=0.024). The conversion rate in the G-vNOTES group was higher than that in the G-vNOTES group (16.95% vs 5.26%, p=0.046). No significant differences were observed in other areas. Conclusions: The PetCO2 in the G-vNOTES group was lower than that in the T-vNOTES group, which may be more beneficial for the treatment of patients with concomitant cardiovascular and pulmonary diseases. The surgical conversion rate of the G-vNOTES group is higher than that of the G-vNOTES group, which may be related to poor surgical field exposure in the G-vNOTES group, making it more suitable for experienced and confident surgeons.

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Gases for establishing pneumoperitoneum during laparoscopic abdominal surgery

Cited by 10 publications

References 62 publications

Carbon footprints in minimally invasive surgery: Good patient outcomes, but costly for the environment

Carbon footprints in minimally invasive surgery: Good patient outcomes, but costly for the environment

Use of mixed gas pneumoperitoneum during minimally invasive surgery: a systematic review of human and mouse modelled laparoscopic interventions

Gasless vNOTES vs traditional vNOTES for benign gynecological disease: a randomized controlled clinical trial

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