Venous Air Embolism during Total Laparoscopic Hysterectomy

Dubar, Gregory; Fischler, Marc

doi:10.1097/aln.0b013e3181c920fc

Cited by 4 publications

(1 citation statement)

References 19 publications

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“…Carbon dioxide (CO 2 ) or gas embolism during laparoscopic surgery has been reported for cholecystectomy,[ 1 – 4 ] radical prostatectomy,[ 5 ] hysterectomy[ 6 ] and even during pediatric laparoscopic procedures. [ 7 – 9 ] We did not come across a single case report of gas embolism during laparoscopic bariatric surgery through Medline search on 9 July 2010.…”

Section: Introductionmentioning

confidence: 99%

Carbon dioxide embolism during laparoscopic sleeve gastrectomy

Zikry

DeSousa

Alanezi

2011

J Anaesthesiol Clin Pharmacol

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Bariatric restrictive and malabsorptive operations are being carried out in most countries laparoscopically. Carbon dioxide or gas embolism has never been reported in obese patients undergoing bariatric surgery. We report a case of carbon dioxide embolism during laparoscopic sleeve gastrectomy (LSG) in a young super obese female patient. Early diagnosis and successful management of this complication are discussed. An 18-year-old super obese female patient with enlarged fatty liver underwent LSG under general anesthesia. During initial intra-peritoneal insufflation with CO2 at high flows through upper left quadrant of the abdomen, she had precipitous fall of end-tidal CO2 and SaO2 % accompanied with tachycardia. Early suspicion led to stoppage of further insufflation. Clinical parameters were stabilized after almost 30 min, while the blood gas analysis was restored to normal levels after 1 h. The area of gas entrainment on the damaged liver was recognized by the surgeon and sealed and the surgery was successfully carried out uneventfully. Like any other laparoscopic surgery, carbon dioxide embolism can occur during bariatric laparoscopic surgery also. Caution should be exercised when Veress needle is inserted through upper left quadrant of the abdomen in patients with enlarged liver. A high degree of suspicion and prompt collaboration between the surgeon and anesthetist can lead to complete recovery from this potentially fatal complication.

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