Impact of a Warm Gas Insufflation on Operating-Room Ergonometrics during Laparoscopic Gastric Bypass: A Pilot Study

Background: With the use of various laparoscopic instruments, the work of operating-room (OR) personnel has increased significantly. The impact of warm gas insufflation on the ergonometrics of the OR was studied, using one of the most involved laparoscopic surgical procedures, Roux-en-Y gastric bypass (RYGBP) for morbid obesity, to assess if use of warm gas insufflation decreases the work of the OR personnel. Methods: 20 patients between August 2003 and January 2004 (6 months) were divided into 2 groups. 10 patients with age 50±10 years and BMI 48±8 underwent laparoscopic RYGBP using a warmed CO_{2 insufflator (WI). These results were compared to 10 patients with age 53±15 years and BMI 51±7 using a non-warmed CO2} insufflator (NWI). Total time of surgery (TOS), time spent cleaning the laparoscope (TCS), time spent changing warm saline (TWS), time spent using anti-fog (TAF), and time the circulating nurse was involved in these activities (TN) were compared. Statistical analysis used a two-sample, Student t-test with unequal variances. Results: The 2 bariatric populations were almost similar in age and BMI. TCS (P<0.0003), TWS (P<0.0001) and TN (P<0.0002) took significantly less time in the WI group, while TOS and TAF were similar. Conclusion: Use of warmed CO₂ insufflation had a significant impact on TCS, TWS and TN. This impacts the ergonometrics of the OR, allowing more time for the personnel and surgeons to concentrate on the surgery.