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High Flow Insufflation for the Maintenance of the Pneumoperitoneum during Bariatric Surgery
Author(s) -
Markos Daskalakis,
Oliver Scheffel,
Rudolf A. Weiner
Publication year - 2009
Publication title -
obesity facts
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.398
H-Index - 45
eISSN - 1662-4033
pISSN - 1662-4025
DOI - 10.1159/000198252
Subject(s) - medicine , pneumoperitoneum , insufflation , surgery , general surgery , laparoscopy
Minimally invasive bariatric procedures next to becoming more and more popular have established a new field of applications for carbon dioxide (CO2) insufflators. In laparoscopic bariatric procedures, gas is used to insufflate the peritoneal cavity and increase the intra-abdominal pressure up to 15 mm Hg for optimal exposure and a suitable operating field. The increased intra-abdominal pressure during pneumoperitoneum can reduce femoral venous flow, intra-operative urine output, portal venous flow, respiratory compliance,and cardiac output. However, clinical complications related to these effects are rare. Yet, surgeons should be constantly aware that the duration of an operation is an important factor in reducing the patient's exposure to CO2 pneumoperitoneum and its adverse effects. The optimized performance of the bariatric high flow insufflator allows reaching stable abdominal pressure conditions quicker and at a higher level than a common insufflator. Therefore, high flow insufflators offer great advantages in maintaining intra-abdominal pressure and temperature in comparison to conventional insufflators and thus enhance laparoscopic bariatric surgery by potentially reducing the operating time and the undesirable effects of CO2 pneumoperitoneum.

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