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> Disorders > Disease or Syndrome > Pneumoperitoneum

Pneumoperitoneum

Pneumoperitoneum refers to the presence of air or gas within the peritoneal cavity, which can occur due to various medical conditions or procedures.
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Most cited protocols related to «Pneumoperitoneum»

1
Standardized Surgical Techniques for LSG and LRYGB
Surgical techniques for LSG and LRYGB were standardized [17 (link)]. Veress needle was used to achieve pneumoperitoneum (15 mmHg). Routine procedure required insertion of four trocars during LSG and five trocars during LRYGB. A sealer/divider or ultrasonic shears were used for a dissection and coagulation (LigaSure Atlas™, Covidien or SonoSurg™, Olympus). A 34-French gastric bougie inserted into the stomach along the lesser curvature was used to calibrate the gastric sleeve. Gastrectomy started 4–5 cm proximal to the pylorus with continuously applied linear staplers, starting with two firings of 60 mm, Ethicon Echelon EndoFlex with gold cartridges (3.8 mm open stapler height, 1.8 mm closed stapler height), then continued with blue cartridges (3.6 mm open stapler height, 1.5 mm closed stapler height) straight to the angle of His. Stapler line was reinforced by a running 3-0 PDS suture. Resected portion of the stomach was removed from the peritoneal cavity through the left flank trocar site during LSG. LRYGB required creation of a pouch by one horizontal 45-mm stapler followed by vertical stapling toward the angle of His, until the pouch was totally separated from the rest of the stomach. Gastrojejunal anastomosis was created with a linear stapler Ethicon Echelon EndoFlex (45 mm, with blue cartridges, open staple height 3.5 mm, closed staple height 1.5 mm) with hand-sewn closure of the remaining defect (3/0 Vicryl, Ethicon). The length of alimentary and enzymatic limb was standardized in all patients, respectively, 150 and 100 cm. Jejunojejunal anastomosis was created using a linear stapler Ethicon Echelon EndoFlex (45 mm, with white cartridge, open staple height 2.5 mm, closed staple height 1 mm). Petersen’s defect was not routinely closed as prevention for internal hernias. A routine 10/12 mm port sites closure was performed to prevent herniation.
Major P., Stefura T., Małczak P., Wysocki M., Witowski J., Kulawik J., Wierdak M., Pisarska M., Pędziwiatr M, & Budzyński A. (2017). Postoperative Care and Functional Recovery After Laparoscopic Sleeve Gastrectomy vs. Laparoscopic Roux-en-Y Gastric Bypass Among Patients Under ERAS Protocol. Obesity Surgery, 28(4), 1031-1039.
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Publication 2017
Coagulation, Blood Dissection Enzymes Gastrectomy Gold Hernia Internal Hernia Needles Operative Surgical Procedures Patients Peritoneal Cavity Pneumoperitoneum Pylorus Staple, Surgical Stomach Surgical Anastomoses Sutures Trocar Ultrasonics Vicryl
2
Preterm Infant NICU Monitoring and Apnea Management
We stored and analyzed the bedside monitor waveforms and vital signs of all infants <35 weeks’ gestation in the University of Virginia NICU from January 2009 through March 2014. The study was approved by the UVA Institutional Review Board as requiring no consent, since all data were analyzed retrospectively and could not influence patient care.
Demographic and clinical data, including dates on and off mechanical ventilation and other respiratory support, were obtained from the electronic medical record. Clinical decisions were made by the care team without knowledge of computer algorithm-detected apneas. Caffeine was given based on our unit policy of initiating caffeine for all infants <32 weeks GA at birth, and discontinuing caffeine after 32 weeks postmenstrual age once the infant was off continuous positive airway pressure and having little or no clinically recognized apnea requiring stimulation. Decisions about dosing and duration of caffeine and readiness for discharge home were based on standard assessment of bedside monitor data, medical record documentation, and nursing reports of apnea events. Generally in our unit during the years of this study, an 8-day period free of apnea requiring stimulation was required prior to discharge.(18 (link))
Clinical events and conditions were recorded in a relational clinical database. Severe intraventricular hemorrhage (IVH) grade III-IV was identified by serial head ultrasounds. Bronchopulmonary dysplasia (BPD) was defined as requirement for supplemental oxygen in our NICU at 36 weeks postmenstrual age. Infants who were transferred to an outside hospital on oxygen prior to 36 weeks’ PMA and for whom the subsequent oxygen status was not known were not included in the BPD analysis. Late-onset septicemia (LOS) was defined as signs of sepsis >3 days from birth, positive blood culture, and antibiotic treatment for at least 5 days. Diagnosis of necrotizing enterocolitis required abdominal signs with abdominal radiograph showing pneumatosis, portal venous air, or pneumoperitoneum, or requirement for surgery. Cases of NEC with associated septicemia were classified as NEC alone. Severe retinopathy of prematurity (ROP) was defined as requiring laser photoablation or intravitreous bevacizumab therapy.
Fairchild K., Mohr M., Paget-Brown A., Tabacaru C., Lake D., Delos J., Moorman J.R, & Kattwinkel J. (2016). Clinical Associations of Immature Breathing in Preterm Infants. Part 1: Central Apnea. Pediatric research, 80(1), 21-27.
Publication 2016
Antibiotics Apnea Bevacizumab Birth Blood Culture Bronchopulmonary Dysplasia Caffeine Continuous Positive Airway Pressure Diagnosis Ethics Committees, Research Head Hemorrhage Infant Laser Ablation Mechanical Ventilation Necrotizing Enterocolitis Operative Surgical Procedures Oxygen Patient Discharge Pneumoperitoneum Pregnancy Radiography, Abdominal Respiratory Rate Retinopathy of Prematurity Septicemia Signs, Vital Therapeutics Therapies, Oxygen Inhalation Ultrasonography Veins, Portal
3
Retrospective Review of Term Infants with NEC

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Publication 2014
Acidosis, Metabolic Apnea Diagnosis Ethics Committees, Research Gestational Age Infant Lethargy Peritonitis Pneumoperitoneum
4
Anubifix™ Embalming and Laparoscopic Exploration
An anatomic specimen embalmed by means of the Anubifix™ method was used. This embalming technique is based on a new prerinsing method combined with a normal 4% formaldehyde fixation solution. In contrast to conventional embalming methods, Anubifix™ embalming results in a very small decrease in flexibility and plasticity. Furthermore, this result is accomplished without impairing the quality and duration of conservation. Anubifix™ embalming results in a preserved range of motion of joints and flexibility of the abdominal wall combined with tissue tactility comparable to fresh-frozen tissues, this all in contrast to conventional embalming methods.
After the embalming phase, a midline laparotomy of 20 cm was performed. The specific aspects of the colorectal anatomy were dissected and marked [aorta and iliac arteries (dark red), superior mesenteric artery/vein and its branches (red/blue), inferior mesenteric artery/vein and its branches (red/blue), gonadal arteries (purple), and ureters (yellow)]. Coloring of the vessels and ureters was performed circumferentially with a specially developed formaldehyde-proof paint (FPP™). After dissection and coloring, the abdominal muscle wall was separated from the overlying fat and skin and closed with running sutures. A rectangular sheet of synthetic butyl rubber measuring 26 × 6 cm with a circular hole at the level of the umbilicus was sutured on top of the sutured muscle wall, analogous to an onlay mesh for incisional hernia, after which the skin was closed with running sutures. The use of a butyl rubber sheet results in an airtight closure of the abdominal wall permitting the creation of a pneumoperitoneum despite the prior abdominal opening. A 10-mm trocar was placed at the umbilicus through which a 30º scope was placed. A standard set of laparoscopic instruments was used. Four 5-mm trocars were placed in the right and left upper quadrants. Pneumoperitoneum was achieved with a continuous flow of CO2, with the pressure set between 12 and 15 mmHg, i.e., comparable to the in vivo situation.
Slieker J.C., Theeuwes H.P., van Rooijen G.L., Lange J.F, & Kleinrensink G.J. (2012). Training in laparoscopic colorectal surgery: a new educational model using specially embalmed human anatomical specimen. Surgical Endoscopy, 26(8), 2189-2194.
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Publication 2012
Abdomen Aorta Arteries Blood Vessel butyl rubber Dental Inlays Dissection Formaldehyde Formalin Freezing Gonads Iliac Artery Incisional Hernia Laparoscopy Laparotomy Mesenteric Arteries, Inferior Muscle Tissue Pneumoperitoneum Pressure Range of Motion, Articular Skin Superior Mesenteric Arteries Sutures Tissues Trocar Umbilicus Ureter Veins Wall, Abdominal
5
Laparoscopic Liver Resection Techniques
All liver resections were intended to be totally laparoscopic and were performed according to the described procedures and the surgeon’s usual practice. The patient was placed in a supine position with the legs apart. Pneumoperitoneum was created by carbon dioxide insufflation at a pressure of 11–12 mmHg, and a 0-degree flexible laparoscope camera was used. When the tumor was located in segment 4, an intraoperative sonographic examination was performed to confirm the exact tumor location and its relationship to major blood vessels. Parenchymal transection was performed with the different types of energy devices (Sonicison, Medtronics or Harmonic Ace, Ethicone or Ligasure, Medtronics) in accordance with the surgeon’s usual practice; devices used were advanced bipolar device, and/or cavitron ultrasonic surgical aspirator (CUSA. EXcel, Valleylab, Boulder, CO). The corresponding Glissonean branch was managed using individual vessel ligation or temporary inflow control of the Glisson (TICGL) method according to the surgeon’s preference [15 (link)]. A temporary increase of intra-abdominal pressure of up to 15 mmHg was used to balance the central venous pressure in case of hepatic vein bleeding. Small vessels were controlled with bipolar coagulation and larger vessels were clipped or electively stapled. Pedicle clamping was not used routinely, but only when there was bleeding or when a long operation time was anticipated. The specimen was removed through in a small low-midline incision followed vertical extension of umbilical port trochar site or a Pfannenstiel incision unless there was a previous laparotomy scar, in which case the previous incision was used. Drain catheter was routinely placed at left upper quadrant.
Kim J.M., Kwon C.H., Yoo H., Kim K.S., Lee J., Kim K., Choi G.S, & Joh J.W. (2018). Which approach is preferred in left hepatocellular carcinoma? Laparoscopic versus open hepatectomy using propensity score matching. BMC Cancer, 18, 668.
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Publication 2018
Abdominal Cavity Blood Vessel Carbon dioxide Catheters Cicatrix Coagulation, Blood Hepatectomy Insufflation Laparoscopes Laparoscopy Laparotomy Leg Ligation Medical Devices Neoplasms Neoplasms by Site Patients Pneumoperitoneum Portal Pressure Pressure Surgeons Trocar Ultrasonic Surgical Procedures Ultrasonography Umbilicus

Most recents protocols related to «Pneumoperitoneum»

1
Laparoscopic Gallbladder Procedure in Pigs
A pig was anesthetized with a mixture of alfaxalone (5 mg/kg), xylazine (2 mg/kg), and azaperone (6 mg/kg), and the following procedures were performed.

i) The 12-mm trocar was placed in the umbilicus of the pig and inflated with CO2 gas. Pneumoperitoneum was created and the intraabdominal pressure was maintained below 12 mmHg.

ii) Two additional ports were placed.

iii) The liver and gallbladder were identified under white light, and the gallbladder was pulled to the peritoneum.

iv) Five millimeters of SF solution was infused directly into the gallbladder. A small bile leak from the infused site was identified and clipped.

v) The biliary structures were observed under blue light emitted from an LED light source.

vi) The pig was euthanized at the end of the procedures.

Kim S., Lee C.M., Lee Y., Han H.J, & Song T.J. (2023). Laparoscopic fluorescence imaging technique for visualizing biliary structures using sodium fluorescein: the result of a preclinical study in a porcine model. Annals of Surgical Treatment and Research, 104(3), 144-149.
Publication 2023
Abdominal Cavity alfaxalone Azaperone Gallbladder Light Liver Peritoneum Pneumoperitoneum Pressure Trocar Umbilicus Xylazine
2
Surgical Condition Evaluation Protocol
Primary outcomes included acceptable surgical condition, surgical condition score, intraoperative movement, and adverse events. Secondary outcomes included additional measures to improve the surgical condition, intraoperative blood loss (mL), duration of surgery (min), pain at 24 h, pain at 48 h, and length of stay (d).
The definitions are as follows: (1) Surgical condition score: Surgical condition scales based on the subjective judgment of the surgeon were commonly used to evaluate the surgical workspace condition, including the 5-point scale (optimal = 5, good but not optimal = 4, moderate = 3, poor but not optimal = 2, poor, and unacceptable = 1) [19 (link)], and the 4-point scale (excellent = 1, good but not optimal = 2, poor but acceptable = 3, unacceptable = 4) [20 (link)]. According to the method of the published research, we converted the 4-point scale to a 5-point scale so that we could pool data in the meta-analysis [8 (link)–11 (link)]. (2) Acceptable surgical condition: Based on surgical condition scales, excellent, optimal, or good but not optimal surgical conditions are not generally thought to interfere with surgical procedures. Therefore, we defined that acceptable surgical condition includes excellent, optimal, and good but not optimal surgical conditions. (3) Intraoperative movement: body movement during surgery. (4) Adverse event: intraoperative and postoperative complications that may be associated with interventions. (5) Additional measures to improve the surgical condition: measures that can improve the surgical condition, including the use of additional NMBAs, changing body position, increasing pneumoperitoneum pressure, and switching to open surgery. (6) Intraoperative blood loss: blood loss during surgery. (7) Duration of surgery: the length of time that surgery continues. (8) Pain: score of the visual analog scale (VAS) or numerical rating scale (NRS), which is converted to a 1–10 range. (9) Length of stay: hospital stays after surgery.
Liu S., He B., Deng L., Li Q, & Wang X. (2023). Does deep neuromuscular blockade provide improved perioperative outcomes in adult patients? A systematic review and meta-analysis of randomized controlled trials. PLOS ONE, 18(3), e0282790.
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Publication 2023
Movement Operative Surgical Procedures Pain Pneumoperitoneum Postoperative Complications Pressure Surgeons Surgical Blood Losses Visual Analog Pain Scale
3
Robotic Ureteral Anastomosis for Transplant
This study was approved by the Institutional Review Board of the Yonsei University College of Medicine (IRB no. 2022-0331-001). All the study protocols were performed in accordance with the principles of the Declaration of Helsinki. Written informed patient consent was waived owing to the retrospective nature of study. The patients were placed in a semi-lateral position similar to the position used for robotic nephrectomy. Pneumoperitoneum was established using the Veress needle technique. The port configuration is shown in Fig. 1. All ports were inserted under direct vision using a laparoscopic camera. The Da Vinci Xi system was docked after port insertion. The 12-mm trocar for the surgical assistant in the lower abdomen was used as a port for robotic instruments (using the piggy-back method) when an additional robotic arm was required [13 (link)]. In this situation, the 5-mm trocar in the subxyphoid area for liver traction was used as a port for the surgical assistant.
After docking the robot, the transplant ureter was dissected, and the stricture site was identified. Nephrectomy of the right native kidney was performed, and the native ureter was harvested. After trimming the native ureter to the appropriate length, the native ureter was attached to the transplant ureter by end-to-side anastomosis. Interrupted suture with 4-0 Vicryl was used for the anastomosis, and a double J ureteral stent was inserted.
Kim J., Yang S.J., Kim D.G., Han W.K, & Na J.C. (2023). Robotic ureter reconstruction using the native ureter to treat long-segment ureteral stricture of the transplant kidney utilizing Indocyanine green: The first Korean experience. Investigative and Clinical Urology, 64(2), 154-160.
Publication 2023
Abdominal Cavity Grafts Kidney Laparoscopy Liver Needles Nephrectomy Operative Surgical Procedures Patients Pharmaceutical Preparations Pneumoperitoneum Stenosis Stents Surgical Anastomoses Sutures Traction Trocar Ureter Vicryl Vision
4
NOSES vs Laparoscopic Colorectal Resection
The modified lithotomy position was taken, and all patients adopted the five trocar position with a pneumoperitoneum of 15 mmHg. One trocar was placed supraumbilical for the camera, while two trocars were placed on the right and left quadrant, respectively. After careful exploration, the patient was placed in the Trendelenburg position. The standard surgical technique was performed both in NOSES group and LAP group including separation and high ligation of the inferior mesenteric vessel, mobilization of the bowel, and dissection of the lymph nodes and and division of the distal rectum. Then the specimen extraction approach was different in two group. After the operation, both groups of patients will have 2 drainage tubes in the pelvic cavity, which are usually removed 5–7 days after the operation.
For LAP group, an auxiliary abdominal incision 6–8 cm in length was made for specimen extraction. Then, the anastomosis was performed by a double-stapling technique under the direct visual observation.
For NOSES group, after mobilization of the rectum and left colon, the distal rectum was transected below the tumor with a linear stapler. An incision was generated below the staple line of the rectal stump and a sterile plastic sleeve was placed into the abdominal cavity through the anus and rectal stump. Next, a long Babcock grasper was brought through the anus, and the specimen was extracted through the plastic sleeve (Figure 2A). Then, an anvil head attached to circular stapling device was inserted into the abdominal cavity, and a longitudinal incision approximately 2 cm was made on proximal colon wall to insert the anvil head (Figure 2B). Subsequently, the proximal colon was transected in close proximity to the upper pole of the incision using a linear stapler. Next, the rectum stump was transected with a linear stapling device. Finally, end-to-end colorectal anastomosis was performed with the use of a circular stapling device (Figure 2C). After the procedure, there is no auxiliary incision in the abdomen (Figure 2D).
Zhao F., Zhao W., Xiao T., Wang Z., Huang F., Xing W, & Liu Q. (2023). Evaluating short-term and survival outcomes of natural orifice specimen extraction surgery for colorectal cancer: A single-centre retrospective study. Frontiers in Surgery, 10, 1078316.
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Publication 2023
Abdomen Abdominal Cavity Amputation Stumps Anus Blood Vessel Colon Drainage Head Intestines Ligation Lymph Node Excision Medical Devices Mesentery Neoplasms Nose Patients Pelvis Pneumoperitoneum Rectum Sterility, Reproductive Surgery, Day Surgical Anastomoses Trocar
5
Perioperative Outcomes in Hypertensive Patients
Data to be evaluated include patient demographics and perioperative outcomes. Demographic characteristics included gender, age, body mass index (BMI), hypertension, diabetes, arrhythmia, ASA score, hormone levels, tumor side, tumor size and CT findings. Perioperative indicators included operation Time, pneumoperitoneum time, estimated blood loss (EBL), hemodynamic instability (HI), time to ambulation, time to oral food, time to removal of drainage, postoperative hospital stay, complications, and BP improvement rate.
The ASA score was used to evaluate the patient’s tolerance to anesthesia. Complications were classified according to the Clavien-Dindo classification (10 (link)). HI was defined as intraoperative BP >180 mmHg or mean arterial pressure <60 mmHg (11 (link)). BP improvement was defined as a decrease in BP after surgery or a decrease in the dose or type of antihypertensive medication taken (12 (link)).
Lei K., Wang X., Yang Z., Liu Y., Sun T., Xie W, & Ma M. (2023). Comparison of the retroperitoneal laparoscopic adrenalectomy versus transperitoneal laparoscopic adrenalectomy for large (≥6cm) pheochromocytomas: A single-centre retrospective study. Frontiers in Oncology, 13, 1043753.
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Publication 2023
Anesthesia Antihypertensive Agents Cardiac Arrhythmia Diabetes Mellitus Drainage Food Gender Hemodynamics Hemorrhage High Blood Pressures Hormones Immune Tolerance Index, Body Mass Neoplasms Operative Surgical Procedures Patients Pneumoperitoneum

Top products related to «Pneumoperitoneum»

1
Ligasure by Medtronic
Sourced in United States, Ireland, Japan
The LigaSure is a surgical instrument manufactured by Medtronic. It is designed to seal blood vessels, tissue bundles, and lymphatics during surgical procedures by delivering a precise combination of pressure and energy. The LigaSure device provides controlled and consistent vessel sealing, enabling efficient tissue dissection and hemostasis.
2
Endoflator by Storz
Sourced in Germany
The Endoflator is a medical device used for insufflation during endoscopic procedures. It is designed to control the flow and pressure of gas, such as carbon dioxide, into the body cavity being examined. The Endoflator provides precise control over the inflation of the body cavity to facilitate the endoscopic visualization and surgical procedures.
3
Da vinci si surgical system by Intuitive Surgical
Sourced in United States
The da Vinci Si Surgical System is a robotic-assisted surgical device designed for minimally invasive surgery. It is composed of a console where the surgeon sits and controls the robotic arms, and a patient-side cart with four robotic arms that hold the surgical instruments. The system allows the surgeon to perform complex surgical procedures with enhanced precision, flexibility, and control.
4
Sils port by Medtronic
Sourced in Ireland, Japan, United States
The SILS Port is a single-incision laparoscopic surgery device manufactured by Medtronic. It is designed to provide access for various surgical instruments during minimally invasive procedures.
5
Rumi uterine manipulator by CooperSurgical
Sourced in United States
The RUMI uterine manipulator is a medical device designed to assist in the positioning and manipulation of the uterus during gynecological procedures. It functions as a tool to provide access and visibility to the uterine area for medical examination or treatment.
6
Da vinci xi by Intuitive Surgical
Sourced in United States
The Da Vinci Xi is a robotic surgical system designed for minimally invasive surgical procedures. It features a high-definition 3D vision system and wristed instruments that provide surgeons with enhanced dexterity and precision.
7
Ligasure device by Medtronic
Sourced in United States
The LigaSure device is a surgical instrument designed for use in medical procedures. It is used to seal blood vessels by applying electrical energy, allowing for precise control and hemostasis during surgery. The LigaSure device provides a compact and efficient solution for tissue sealing and cutting.
8
Da vinci si by Intuitive Surgical
Sourced in United States
The da Vinci Si is a surgical system designed to perform minimally invasive procedures. It consists of a surgeon's console, a patient-side cart with four robotic arms, and a high-definition 3D vision system. The system allows the surgeon to control the instruments with precision, flexibility, and control.
9
Da vinci robotic system by Intuitive Surgical
Sourced in United States
The da Vinci robotic system is a computer-assisted surgical device designed to facilitate complex surgical procedures. The system consists of a surgeon's console, a patient-side robot with four interactive robotic arms, and a high-definition 3D vision system. The core function of the da Vinci system is to translate the surgeon's hand movements into more precise and controlled movements of the surgical instruments within the patient's body.
10
Primus anesthesia machine by Dräger
Sourced in Germany
The Primus® anesthesia machine is a medical device designed to deliver and monitor anesthetic gases and oxygen during surgical procedures. It is capable of providing a controlled flow of gases to the patient and monitoring various parameters related to the anesthetic delivery.

More about "Pneumoperitoneum"

Pneumoperitoneum is a medical condition characterized by the presence of air or gas within the peritoneal cavity, the space surrounding the abdominal organs.
This can occur due to various medical conditions or procedures, such as perforated viscus, trauma, or surgical interventions.
Pneumoperitoneum can be caused by a variety of factors, including: - Gastrointestinal perforations (e.g., from peptic ulcers, diverticulitis, or appendicitis) - Trauma (e.g., blunt or penetrating abdominal injuries) - Surgical procedures (e.g., laparoscopic surgery, abdominal operations) - Certain medical conditions (e.g., chronic obstructive pulmonary disease, barotrauma) The presence of air or gas in the peritoneal cavity can lead to various symptoms, such as abdominal pain, distension, and difficulty breathing.
Prompt diagnosis and appropriate treatment are essential to manage pneumoperitoneum and its underlying cause.
Diagnostic tools used to detect pneumoperitoneum include imaging techniques like plain abdominal radiography, computed tomography (CT) scans, and, in some cases, ultrasonography.
Additionally, specialized medical devices like the LigaSure™ vessel sealing system, Endoflator® insufflation unit, and Da Vinci Si™ Surgical System may be utilized during surgical interventions to address the condition.
The management of pneumoperitoneum typically involves treating the underlying cause, which may require surgical or non-surgical interventions.
In some cases, the SILS Port™ or RUMI® uterine manipulator may be used during minimally invasive procedures.
The Da Vinci Xi® robotic system and Primus® anesthesia machine may also play a role in the treatment and management of pneumoperitoneum.
By gaining a comprehensive understanding of pneumoperitoneum, its causes, and the available diagnostic and treatment options, healthcare professionals can provide effective care and improve patient outcomes.
Exploring the AI-driven analysis platform at PubCompare.ai can further enhance research efforts related to pneumoperitoneum and related medical conditions.