Document Detail


Endoscopy during laparoscopy. Reduced postprocedural bowel distention with intraluminal CO2 insufflation.
MedLine Citation:
PMID:  10384071     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Intraluminal endoscopy during laparoscopy can substitute for manual palpation in defining anatomy and pathology, but a potential problem is the persistent bowel distention associated with intraluminal air insufflation. METHODS: To compare the rates of intraluminal absorption, a 30-cm segment of small bowel with an intact vascular supply was insufflated with either air or CO2 during CO2 pneumoperitoneum. Intraluminal pressures and bowel circumferences were monitored after the insufflation was stopped. To study the metabolic and hemodynamic effects of CO2 endoscopy during laparoscopy, the small bowel was insufflated to an intraluminal pressure of 15 mmHg during CO2 pneumoperitoneum. Nitrogen pneumoperitoneum was used to differentiate the effects from intraluminal and peritoneal CO2 insufflation. RESULTS: The intraluminal pressures remained elevated and the bowel distended for the entire 3 h following bowel insufflation with air. Following intraluminal CO2 insufflation, both the intraluminal pressures and the bowel circumferences returned to preinsufflation values within 15 min. Intraluminal CO2 insufflation also led to systemic absorption of CO2 with significant metabolic and hemodynamic changes. These changes were effectively corrected by doubling minute ventilation. CONCLUSIONS: Intraluminal CO2 was absorbed faster than intraluminal air. Although decreased bowel distention is certainly of practical value, endotracheal intubation needs to be done to effectively ventilate the absorbed CO2.
Authors:
A Silva; H S Ho; K A Mathiesen; B M Wolfe
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Surgical endoscopy     Volume:  13     ISSN:  0930-2794     ISO Abbreviation:  Surg Endosc     Publication Date:  1999 Jul 
Date Detail:
Created Date:  1999-08-10     Completed Date:  1999-08-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  662-7     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of California, Davis, School of Medicine, Davis, CA 95817, USA.
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MeSH Terms
Descriptor/Qualifier:
Air
Analysis of Variance
Animals
Carbon Dioxide / metabolism*
Endoscopy, Digestive System*
Hemodynamics
Insufflation / methods*
Intestine, Small / metabolism*
Laparoscopy*
Pneumoperitoneum, Artificial / methods
Random Allocation
Swine
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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