Laparoscopic Surgery

Lavina Belayutham

Creation of pneumoperitoneum

Created using veress needle through umbilical incision

Access achieved by open method through an umbilical incision

Pneumoperitoneum created upto a pressure of 15mmHg which distends the abdominal cavity adequately to have proper visualisation of the abdominal contents.

Gases used :- Carbon dioxide (commonly used)- Air- Nitrous oxide- Helium- Argon

Why is carbon dioxide commonly used to create pneumoperitoneum?

1.Readily available2.Cheaper3.Suppresses the combustion4.Easily absorbed by tissues5.Has high diffusion coefficient6.Quickly released via respiration

Physiologic changes due to pneumoperitoneum:1.Carbon dioxide causes hypercarbia, acidosis

and hypoxia2.Pneumoperitoneum exerts pressure on the

IVC, decreases the venous return and so the cardiac output

3.It increases the arterial pressure4.Compromises respiratory function by

compressing over the diaphragm impairing the pulmonary compliance