Abstract
Laparoscopy is now a common minimally invasive technique with an increasing number of benefits for the patient and to some degree for the delivery of health care. Laparoscopic procedures use CO2 gas at a temperature of –19 to 21ºC with a relative humidity approaching 0% at the point of entry into the peritoneal cavity, which is not identical to its normal physiological conditions. Studies of laparoscopic insufflation have demonstrated that cold, dry CO2 insufflation can lead to peritoneal consequences and result in numerous detrimental outcomes, including hypothermia, and increased pain and narcotics consumption, as well as prolonged delayed recovery. Many studies were made in the past decade on the warming and humidification of CO2. Two different opinions still exist, one supporting warming and humidification, and the other against it.
The side effects of cold and dry CO2 must be prevented. New prospective, blind clinical studies must be carried out with different techniques of warming and humidification, and different temperatures and humidification concentrations using consistently large patient groups by skilled surgical and anesthesia teams.
Keywords
- Laparoscopic Surgery
- Postoperative Pain
- Laparoscopic Cholecystectomy
- Laparoscopic Colonic Surgery
- Large Internal Surface Area
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Glavic Z, Begic L, Simlesa D, Rukavina A (2001) Treatment of acute cholecystitis. A comparison of open vs laparoscopic cholecytectomy. Surg Endosc 15:398–401
Rist Max, Hemmelig TM, Rawh R, Siebzehnrübl E, Jacobi KE (2001) Influence of pneumoperitoneum and patient positioning on preload and splanchnic blood volume in laparoscopic surgery of lower abdomen. J Clin Anesth 13:244–249
Erikoglu M, Yol S, Avunduk MC, Erdemli E, Can A (2005) Electron-microscopic alterations of the peritoneum after both cold and heated carbon dioxide pneumoperitoneum. J Surg Res 125:73–77
Hamza MA, Schneider BE, White PF et al (2005) Heated and humidified insufflation during laparoscopic gastric bypass surgery: effect on temperature, postoperation pain, and recovery outcomes. J Laparoendosc Adv Surg Tech A 15:6
Schlotterbeck H, Greib N, Dow AW, Schaeffer R, Geny B, Diemunsch P (2010) Changes in core temperature during peritoneal insufflation: comparison of two CO2 humidification devices in pigs. J Surg Res. 1–6. doi:10.1016/j.jss.2010.04.003
Schlotterbeck H, Schaeffer R, Dow AW, Diemunsch P (2008) Cold nebulization used to prevent heat loss during laparoscopic surgery: an experimental study in pigs. Surg Endosc 22:2616–2620
Sammour T, Kahokehr A, Hayes J, Hulme-Moir M, Hill GA (2010) Warming and humidification carbon dioxide in laparoscopic colonic surgery. Ann Surg 251:1024–1033
Savel Rh, Balasubramanya S, Lazheer S, Gaprindashuili, Arabou E, Fazylou RM, Lazzaro RS, Macura JM (2005) Beneficial effects of humidified, warmed carbon dioxide insufflation during laparoscopic bariatric surgery: a randomized clinical trial. Obes Surg 15:64–69
Wong YT, Shab PC, Birkett HD, Brams DM (2004) Carbon dioxide pneumoperitoneum causes severe peritoneal acidosis, unaltered by heating, humidification, or bicarbonate in a porcine model. Surg Endosc 18:1498–1503
Farley DR, Greenlee SM, Larson DR, Harrington JR (2004) Double-blind, prospective, randomized study of warmed, humidified, carbon dioxide insufflation vs standard carbon dioxide for patients undergoing laparoscopic cholecystectomy. Arch Surg 139:739–744
Mauton WG, Bessell JR, Millard SH, Baxter PS, Maddein GJ (1999) A randomized controlled trial assessing the benefits of humidified insufflation gas during laparoscopic surgery. Surg Endosc 13:106–108
Peng Y, Zheng M, Ye Q, Chen X, Yu B, Liu B (2009) Heated and humidified CO2 prevents hypothermia peritoneal injury, and intra-abdominal adhesions during prolonged laparoscopic insufflations. J Surg Res 151:40–47
Benavides R, Wong A, Nguyen H (2009) Improved outcomes for lap-banding using the insflow® device compared with heated-only gas. JSLS 13:302–305
Sammour T, Kahokehr Ai Hill AG (2008) Meta-analysis of the effect of warm humidified insufflation on pain after laparoscopy. Br J Surg 95:950–956
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© 2012 Springer-Verlag Berlin Heidelberg
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Koksal, G.M., Erbabacan, E. (2012). Humidification During Laparoscopy Procedures: Key Topics Technologic and Clinical Implication. In: Esquinas, A. (eds) Humidification in the Intensive Care Unit. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-02974-5_19
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DOI: https://doi.org/10.1007/978-3-642-02974-5_19
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