Open AccessCarbon dioxide gas embolism during robot‐assisted laparoscopic partial nephrectomy
Author(s) -
Nakagawa Ryunosuke,
Nohara Takahiro,
Kadomoto Suguru,
Iwamoto Hiroaki,
Yaegashi Hiroshi,
Iijima Masashi,
Kawaguchi Shohei,
Shigehara Kazuyoshi,
Izumi Kouji,
Kadono Yoshifumi,
Mizokami Atsushi
Publication year - 2022
Publication title -
iju case reports
Language(s) - English
Resource type - Journals
ISSN - 2577-171X
DOI - 10.1002/iju5.12472
Subject(s) - pneumoperitoneum , nephrectomy , medicine , embolism , air embolism , surgery , partial pressure , pulmonary embolism , anesthesia , laparoscopy , kidney , oxygen , complication , chemistry , organic chemistry
One of the complications of laparoscopic surgery is gas embolism, which has low incidence but high mortality. Carbon dioxide embolism diagnosed during robot‐assisted laparoscopic partial nephrectomy has been experienced. Case presentation 77‐year‐old woman with a left renal tumor received robot‐assisted laparoscopic partial nephrectomy. End‐tidal carbon dioxide pressure and oxygen saturation of peripheral artery suddenly decreased 5 min after the start of tumor resection with pneumoperitoneum pressure of 15 mmHg and positive end‐expiratory pressure turned off. Therefore, pulmonary artery gas embolism was diagnosed. The pneumoperitoneum pressure was dropped, and positive end‐expiratory pressure was restarted. These conditions improved and the procedure was completed. Conclusion Carbon dioxide gas embolism during robot‐assisted partial nephrectomy should be focused on because prompt diagnosis and treatment will improve life outcomes. The optimal pneumoperitoneum pressure for each case, rather than making it uniform, should be reconsidered.