World Journal of Laparoscopic Surgery

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VOLUME 7 , ISSUE 1 ( January-April, 2014 ) > List of Articles

REVIEW ARTICLE

Co2-Pneumoperitoneum in Laparoscopic Surgery: Pathophysiologic Effects and Clinical Significance

Šefik Hasukiæ

Citation Information : Hasukiæ Š. Co2-Pneumoperitoneum in Laparoscopic Surgery: Pathophysiologic Effects and Clinical Significance. World J Lap Surg 2014; 7 (1):33-40.

DOI: 10.5005/jp-journals-10033-1214

Published Online: 01-04-2014

Copyright Statement:  Copyright © 2014; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background

Knowledge of the pathophysiological basis of laparoscopic procedures, in particular the impact of CO2-pneumoperitoneum (PNP) on the body, can prevent onset of complications during laparoscopy.

Design and Methods

Standard intra-abdominal pressure (IAP), which is used during laparoscopic surgery, is 12 to 15 mm Hg. The direct effect of CO2-pneumoperitoneum is a consequence of the mechanical action of the gas, and increased intra-abdominal pressure. The indirect effect of CO2-pneumoperitoneum caused by the absorption of gas from the abdomen. Analysis of articles that evaluated the effects of CO2-pneumoperitoneum on the body and intra-abdominal organs contributes to an even better use of the laparoscopic method.

Results

The results of numerous experimental and clinical studies have confirmed that increased IAP and CO2-pneumoperitoneum intraoperatively causing reduction the portal venous blood flow, increasing venous stasis, reduced glomerular filtration, reduced Tiffeneau-index and pulmonary compliance what it can lead to hemodynamic and cardiac disorders. Consecutive intraoperative acidosis and hipercarbia impact the function of intra-abdominal organs and heart.

Conclusion

To avoid the side effects of CO2-pneumoperitoneum, which is important in patients with ASA II and more often as necessary to be operate with low pressure (IAP: 6-8 mm Hg) or use gasless laparoscopy.

How to cite this article

Hasukiæ Š. CO2-Pneumoperitoneum in Laparoscopic Surgery: Pathophysiologic Effects and Clinical Significance. World J Lap Surg 2014;7(1):33-40.


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