| Measurements of intraperitoneal pressure and the development of a feedback control valve for regulating pressure during flexible transgastric surgery (NOTES). | |
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MedLine Citation:
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PMID: 17591494 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Maria Bergström; Paul Swain; Per-Ola Park |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Gastrointestinal endoscopy Volume: 66 ISSN: 0016-5107 ISO Abbreviation: Gastrointest. Endosc. Publication Date: 2007 Jul |
Date Detail:
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Created Date: 2007-06-26 Completed Date: 2007-10-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0010505 Medline TA: Gastrointest Endosc Country: United States |
Other Details:
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Languages: eng Pagination: 174-8 Citation Subset: IM |
Affiliation:
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Sahlgrenska University Hospital/Ostra, Göteborg, Sweden. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Cholecystectomy, Laparoscopic* Feedback Female Gastroscopes Monitoring, Intraoperative / instrumentation* Peritoneal Cavity / physiology* Pneumoperitoneum, Artificial / instrumentation* Pressure Sterilization, Tubal* Swine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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