can make the ventilated lung more fragile and increase the risk of developing VILI.
Then after starting and up to 40 mins of pneumoperitoneum
SBP was significantly lower with dexmedetomidine than with magnesium sulphate and control groups (p value < 0.05).
However, because laparoscopy is relatively new, it still arouses controversy, particularly with regard to the best method for the creation of the pneumoperitoneum
. Traditional closed method of pneumoperitoneum
involves initial blind entry into abdomen and more than half of such injuries are related to this primary blind access and occur before the start of actual anatomic dissection.
Again, 3 consecutive failures were taken as 'Failed procedure' and the pneumoperitoneum
was created by open method.
means that the intra-peritoneal air exerts so much pressure on the circulatory and respiratory systems that it causes respiratory distress and hypotension.
was drained right after exposure of the urethra.
was created by intraperitoneal insufflation of C[O.sub.2], with the patient in the supine position.
Bedsides, chest X-ray was negative for tympanic abdomen or pneumoperitoneum
. At that point an exploratory laparotomy was decided upon.
The Hasson technique was used to create pneumoperitoneum
2 cm above the umbilicus, and three operative trocars were placed in the same sites of the previous operation (one 12 mm trocar in the left hypochondrium and two 5 mm trocars, respectively, under the xiphoid and in the right hypochondrium).
A veress needle was inserted along the lower edge of navel to establish CO2 pneumoperitoneum
; pressure was kept at 8~10 mmHg.
was observed on abdominal X-ray in standing position (Figure 1).
This increased pressure is well known to affect acute glaucoma due to increased venous pressure within the eye and is further increased by carbon dioxide retention from pneumoperitoneum
during laparoscopic surgery [5, 6].