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Accurate use of laparoscopic pneumoperitoneum operation
Jul 04, 2018

Endoscopic surgery is widely used in clinical practice because of its advantages of small trauma, less pain, quick recovery, and economical graphic workstations. CO2 pneumoperitoneum is the root of laparoscopic surgery. The establishment of the pneumoperitoneum increases the pressure in the abdominal cavity, and the lifting of the diaphragm will have a certain impact on the system of breathing and circulation of the body. Therefore, how to operate the pneumoperitoneum, establish and maintain a successful pneumoperitoneum, provide an excellent vision and satisfactory operating space for the operation, and at the same time bring serious adverse consequences to the body without pneumonia, to ensure surgery and titanium clamp patients Safety is the key to cooperation in laparoscopic surgery. After the cooperation of laparoscopic surgery such as gynecology, hepatobiliary surgery, etc., the safe operation of the pneumoperitoneum is stated as follows:

1 Preparation before use

1.1 Connect the pneumothorax machine and the CO2 cylinder, open the valve of the CO2 cylinder and check that there is no air leakage.

1.2 Connect the power supply, turn on the power switch, check the pressure of the CO2 cylinder.

1.3 After adjusting various parameters, press the gas injection button to remove the residual gas from the host. Then close the gas injection button and clear the accumulated gas volume for use.

2 intra-abdominal pressure value setting

After the pneumoperitoneum is established, the intra-abdominal pressure is increased, the diaphragm is lifted up, and the respiratory movement is limited: the extra-abdominal pressure in the abdominal cavity is increased: the absorption of CO2 into the blood in the abdominal cavity may cause an increase in blood Pcco2 and respiratory acidosis. The higher the pneumoperitoneum pressure, the more significant these changes are, but the higher the pneumoperitoneum pressure, the wider the surgical field. The preset value of the intra-abdominal pressure of the pneumoperitoneum is the highest value of the appropriate abundance of internal pressure for satisfactory surgical needs and patient safety. It varies according to the patient's age, weight, vital signs, special illnesses, etc. The preset value of intra-abdominal pressure.

2.1 The default value of intra-abdominal pressure in children: newborns are generally 0.8 to 1.0 kpa, and children are 1 to 1.2 kpa.

2.2 Adult air pressure in the abdominal cavity is preset to 1.6 ~ 1.9 kpa, not exceeding 2 kpa.

2.3 Fat and strong patients, when the establishment of pneumoperitoneum can be properly improved but does not exceed 2.6 kpa, immediately after entering the first set of pipelines, immediately fell to normal values.

2.4 Newborns, patients with cardiopulmonary dysfunction should appropriately reduce the setting of intra-abdominal pressure values, and pay attention to investigating changes in vital signs of patients to prevent the onset of complications.

2.5 In the case of satisfactory surgical needs, try to use lower intra-abdominal pressure.


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