Pulmonary CO2 Elimination During Surgical Procedures Using Intra- or Extraperitoneal CO2 Insufflation

Hemodynamics during laparoscopic extra- and intraperitoneal insufflation

“…These findings are in agreement with others that showed, in an experimental study in dogs, that if the insufflated gas is limited to the retroperitoneal space, the absorption of CO 2 appears to be reduced compared to intraperitoneal insufflation [14]. These findings contrast with a study that showed more marked CO 2 diffusion into the body during extraperitoneal than during intraperitoneal CO 2 insufflation [11]. However, in that study three different operations were evaluated, which might have influenced the results.…”

Effect of age on pulmonary gas exchange during laparoscopy in the Trendelenburg lithotomy position

“…Therefore, increase in the gradient shown in the present study may be, in part, attributable to reduction of CO (14). Increase in intraabdominal pressure up to 20 cmH 2 O has been reported to an increase (15) or no change in CO (16). Insufflation pressure in the present study did not exceed 19 cmH 2 O, and therefore CO was likely to be increased or at least unchanged even in the E group.…”

“…With CO 2 insufflation in the Trendelenburg-lithotomy position, the setting of mechanical ventilation based on the value of PET CO2 should be determined with caution in elderly patients. Insufflation pressure; mmHg 13 (7)(8)(9)(10)(11)(12)(13)(14) 12 (9)(10)(11)(12)(13)(14) 12 (9)(10)(11)(12)(13)(14) Degree against horizontal line; degree 23 (14-30) 24.5 (14-32) 23 (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) N: number of patients…”

Laparoscopic cholecystectomy using abdominal wall retraction

“…This finding is in agreement with those of others who showed that the increase of PCO 2 during laparoscopy is not linearly related to the intraabdominal pressure of CO 2 pneumoperitoneum [8]. It is suggested that recruitment of peritoneal absorption area is an important factor to determine the rate of CO 2 absorption from the peritoneal cavity [8,9]. It is conceivable that recruitment of more gas-exchange area during abdominal wall retraction may result in an increase of PCO 2 similar to the increase observed at higher intraabdominal pressures.…”