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At least 595 records · Page 33Linked to original sources
PubMed1995

Retroperitoneoscopy: effects of insufflation media on surrounding tissue during balloon rupture.

There has been recent interest in using balloon dilation to create an extraperitoneal working space to perform retroperitoneoscopy. Balloon dilation is not without risk, and incorrect placement or rupture can result in tissue damage. We developed an ex vivo model to assess the effect of various filling media on tissue injury during balloon rupture. As would be expected from theoretical considerations, greater energy was released during rupture of the gas-filled balloon than a liquid-filled balloon. These data indicate that liquid filling medium is preferable to gas when creating an extraperitoneal working space.

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PubMed2006

Safe and novel technique for peritoneal access in urologic laparoscopy without prior insufflation.

BACKGROUND AND PURPOSE: Access to the peritoneum for transperitoneal laparoscopic surgery can be achieved using a variety of techniques, each of which has advantages and disadvantages as well as risks of complications. The endoscopic threaded imaging port (EndoTIP) is a metal, reusable, threaded visual-access cannula that is inserted by rotational rather than axial force. When the technique was described initially, capnoperitoneum was obtained prior to trocar insertion. We describe the results of our series using the EndoTIP port without prior capnoperitoneum. PATIENTS AND METHODS: All 165 patients who underwent urologic transperitoneal laparoscopic procedures using the EndoTIP performed by a single surgeon from October 2001 through June 2005 were reviewed. Twentyfive patients were morbidly obese, and 32 had had previous abdominal surgical procedures. All data regarding patient demographics, details of the procedures, and outcomes were obtained from a database developed for prospective data collection at our institution. RESULTS: There were no complications associated with peritoneal access or trocar insertion. The average time required to obtain capnoperitoneum was <1 minute. CONCLUSIONS: Insertion of the EndoTIP port without prior capnoperitoneum is a safe, quick, and reliable method for peritoneal access in laparoscopic surgery. By avoiding blind punctures of the abdominal cavity, the risk of complications during access is minimized. We believe this technique should be considered in preference to techniques where trocars are inserted blindly.

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PubMed1994

Hyperkalaemia associated with prolonged insufflation of carbon dioxide into the peritoneal cavity.

We measured plasma potassium concentrations in five anaesthetized pigs over a 3.5 h period during which a carbon dioxide pneumoperitoneum was maintained. During this period the abdominal pressure was kept at 1.96 kPa and normocapnia was maintained by intermittent positive pressure ventilation. The potassium concentration was found to increase with time to a mean of 5.63 (SD 0.44) mmol litre-1. Consideration should be given to monitoring plasma potassium concentration in patients undergoing prolonged laparoscopic surgery.

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