Document Detail

Measurements of intraperitoneal pressure and the development of a feedback control valve for regulating pressure during flexible transgastric surgery (NOTES).
MedLine Citation:
PMID:  17591494     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: High intraabdominal pressures during laparoscopy (greater than 15 mm Hg) are dangerous. Pressures developed during translumenal endosurgery when using flexible endoscopes without feed-back regulation are unknown. OBJECTIVE: To measure and control intraabdominal pressures during transgastric endosurgery. DESIGN: In a blinded study, intraabdominal pressures during unregulated transgastric cholecystectomy and tubal ligation were measured by using Veress needles in 5 pigs (group 1). The accessory channel valve of a double-channel gastroscope was modified to allow measurement and control of intraabdominal pressures with a laparoscopic insufflator. This was tested prospectively in another blinded study in 5 pigs (group 2) that underwent identical procedures to those in group 1, with independent Veress needle pressure measurements. SETTING: This ethically approved study was performed in an experimental surgical operating theater. INTERVENTIONS: Transgastric cholecystectomy (n=4) and tubal resection (n=6). MAIN OUTCOME MEASURES: Intraabdominal pressure measurements during transgastric endosurgery, with and without feed-back control. RESULTS: The mean (standard deviation) number of pressure measurements per procedure greater than 20 mm Hg was 11+/-1.41 in group 1 and 0+/-0 in group 2 (P<.05). Most episodes of high pressure were undetected by the endoscopist, who was blinded to the pressure measurements. CONCLUSIONS: Unacceptably high intraabdominal pressures were common during translumenal endosurgical procedures. Feedback pressure regulation through a modified valve prevented overinflation.
Maria Bergström; Paul Swain; Per-Ola Park
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  66     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-26     Completed Date:  2007-10-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  174-8     Citation Subset:  IM    
Sahlgrenska University Hospital/Ostra, Göteborg, Sweden.
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MeSH Terms
Cholecystectomy, Laparoscopic*
Monitoring, Intraoperative / instrumentation*
Peritoneal Cavity / physiology*
Pneumoperitoneum, Artificial / instrumentation*
Sterilization, Tubal*

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