Skip to main content
Top
Published in: Surgical Endoscopy 3/2005

01-03-2005 | Original article

Intraoperative carbon dioxide colonoscopy: a safe insufflation alternative for locating colonic lesions during laparoscopic surgery

Authors: K. Nakajima, S. W. Lee, T. Sonoda, J. W. Milsom

Published in: Surgical Endoscopy | Issue 3/2005

Login to get access

Abstract

Background

Intraoperative colonoscopy (IOC) is useful for locating colonic pathologies during laparoscopy, but bowel distention compromises the subsequent visualization and procedure. Carbon dioxide (CO2), with its rapid absorption, has been proved effective for alleviating bowel distention in ambulatory settings. Its intraoperative role, however, has never been studied. This study aimed to assess the feasibility, safety, and advantages of CO2-insufflated IOC during laparoscopy.

Methods

For this study, CO2-insufflated IOC was performed for 20 patients under CO2 pneumoperitoneum. Parameters, including end-tidal CO2 (ETCO2) and minute volume, were prospectively registered. Time until resolution of bowel distention was determined by laparoscopic evaluation.

Results

All lesions were located by CO2-insufflated IOC in 15 min. During IOC, ETCO2 increased, but remained within normal values, and was quickly compensated with minimal hyperventilation. Bowel distention totally disappeared in 21 min, allowing immediate initiation of laparoscopic procedures under adequate visualization.

Conclusions

The findings show that CO2-insufflated IOC during laparoscopy is feasible, safe, and of practical value for minimizing bowel distention without impeding the subsequent visualization and procedure.
Literature
1.
go back to reference Avgerinos, A, Kalantzis, N, Rekoumis, G, Pallikaris, G, Arapakis, G, Kanaghinis, T 1984Bowel preparation and the risk of explosion during colonoscopic polypectomyGut25361364PubMed Avgerinos, A, Kalantzis, N, Rekoumis, G, Pallikaris, G, Arapakis, G, Kanaghinis, T 1984Bowel preparation and the risk of explosion during colonoscopic polypectomyGut25361364PubMed
2.
go back to reference Bond, JHJ, Levitt, MD 1975Factors affecting the concentration of combustible gases in the colon during colonoscopyGastroenterology6814451448PubMed Bond, JHJ, Levitt, MD 1975Factors affecting the concentration of combustible gases in the colon during colonoscopyGastroenterology6814451448PubMed
3.
go back to reference Brandt, LJ, Boley, SJ, Sammartano, R 1986Carbon dioxide and room air insufflation of the colon: effects on colonic blood flow and intraluminal pressure in the dogGastrointest Endosc32324329PubMed Brandt, LJ, Boley, SJ, Sammartano, R 1986Carbon dioxide and room air insufflation of the colon: effects on colonic blood flow and intraluminal pressure in the dogGastrointest Endosc32324329PubMed
4.
go back to reference Bretthauer, M, Thiis-Evensen, E, Huppertz-Hauss, G, Gisselsson, L, Grotmol, T, Skovlund, E, Hoff, G 2002NORCCAP (Norwegian colorectal cancer prevention): a randomised trial to assess the safety and efficacy of carbon dioxide versus air insufflation in colonoscopyGut50604607CrossRefPubMed Bretthauer, M, Thiis-Evensen, E, Huppertz-Hauss, G, Gisselsson, L, Grotmol, T, Skovlund, E, Hoff, G 2002NORCCAP (Norwegian colorectal cancer prevention): a randomised trial to assess the safety and efficacy of carbon dioxide versus air insufflation in colonoscopyGut50604607CrossRefPubMed
5.
go back to reference Brullet, E, Montane, JM, Bombardo, J, Bonfill, X, Nogue, M, Bordas, JM 1992Intraoperative colonoscopy in patients with colorectal cancerBr J Surg7913761378PubMed Brullet, E, Montane, JM, Bombardo, J, Bonfill, X, Nogue, M, Bordas, JM 1992Intraoperative colonoscopy in patients with colorectal cancerBr J Surg7913761378PubMed
6.
go back to reference Church, J, Delaney, C 2003Randomized, controlled trial of carbon dioxide insufflation during colonoscopyDis Colon Rectum46322326CrossRefPubMed Church, J, Delaney, C 2003Randomized, controlled trial of carbon dioxide insufflation during colonoscopyDis Colon Rectum46322326CrossRefPubMed
7.
go back to reference Hussein, AM, Bartram, CI, Williams, CB 1984Carbon dioxide insufflation for more comfortable colonoscopyGastrointest Endosc306870PubMed Hussein, AM, Bartram, CI, Williams, CB 1984Carbon dioxide insufflation for more comfortable colonoscopyGastrointest Endosc306870PubMed
8.
go back to reference Kim, SH, Milsom, JW, Church, JM, Ludwig, KA, Garcia-Ruiz, A, Okuda, J, Fazio, VW 1997Perioperative tumor localization for laparoscopic colorectal surgerySurg Endosc1110131016PubMed Kim, SH, Milsom, JW, Church, JM, Ludwig, KA, Garcia-Ruiz, A, Okuda, J, Fazio, VW 1997Perioperative tumor localization for laparoscopic colorectal surgerySurg Endosc1110131016PubMed
9.
go back to reference Montorsi, M, Opocher, E, Santambrogio, R, Bianchi, P, Faranda, C, Arcidiacono, P, Passoni, GR, Cosentino, F 1999Original technique for small colorectal tumor localization during laparoscopic surgeryDis Colon Rectum42819822PubMed Montorsi, M, Opocher, E, Santambrogio, R, Bianchi, P, Faranda, C, Arcidiacono, P, Passoni, GR, Cosentino, F 1999Original technique for small colorectal tumor localization during laparoscopic surgeryDis Colon Rectum42819822PubMed
10.
go back to reference Phaosawasdi, K, Cooley, W, Wheeler, J, Rice, P 1986Carbon dioxide-insufflated colonoscopy: an ignored superior techniqueGastrointest Endosc32330333PubMed Phaosawasdi, K, Cooley, W, Wheeler, J, Rice, P 1986Carbon dioxide-insufflated colonoscopy: an ignored superior techniqueGastrointest Endosc32330333PubMed
11.
go back to reference Rogers, BH 1974The safety of carbon dioxide insufflation during colonoscopic electrosurgical polypectomyGastrointest Endosc20115117PubMed Rogers, BH 1974The safety of carbon dioxide insufflation during colonoscopic electrosurgical polypectomyGastrointest Endosc20115117PubMed
12.
go back to reference Saltzman, HA, Sieker, HO 1968Intestinal response to changing gaseous environments: normobaric and hyperbaric observationsAnn N Y Acad Sci1503139PubMed Saltzman, HA, Sieker, HO 1968Intestinal response to changing gaseous environments: normobaric and hyperbaric observationsAnn N Y Acad Sci1503139PubMed
13.
go back to reference Stevenson, GW, Wilson, JA, Wilkinson, J, Norman, G, Goodacre, RL 1992Pain following colonoscopy: elimination with carbon dioxideGastrointest Endosc38564567PubMed Stevenson, GW, Wilson, JA, Wilkinson, J, Norman, G, Goodacre, RL 1992Pain following colonoscopy: elimination with carbon dioxideGastrointest Endosc38564567PubMed
14.
go back to reference Sumanac, K, Zealley, I, Fox, BM, Rawlinson, J, Salena, B, Marshall, JK, Stevenson, GW, Hunt, RH 2002Minimizing postcolonoscopy abdominal pain by using CO2 insufflation: a prospective, randomized, double-blind, controlled trial evaluating a new commercially available CO2 delivery systemGastrointest Endosc56190194CrossRefPubMed Sumanac, K, Zealley, I, Fox, BM, Rawlinson, J, Salena, B, Marshall, JK, Stevenson, GW, Hunt, RH 2002Minimizing postcolonoscopy abdominal pain by using CO2 insufflation: a prospective, randomized, double-blind, controlled trial evaluating a new commercially available CO2 delivery systemGastrointest Endosc56190194CrossRefPubMed
15.
go back to reference Taylor, EW, Bentley, S, Youngs, D, Keighley, MR 1981Bowel preparation and the safety of colonoscopic polypectomyGastroenterology8114PubMed Taylor, EW, Bentley, S, Youngs, D, Keighley, MR 1981Bowel preparation and the safety of colonoscopic polypectomyGastroenterology8114PubMed
16.
17.
go back to reference Zmora, O, Dinnewitzer, AJ, Pikarsky, AJ, Efron, JE, Weiss, EG, Nogueras, JJ, Wexner, SD 2002Intraoperative endoscopy in laparoscopic colectomySurg Endosc16808811CrossRefPubMed Zmora, O, Dinnewitzer, AJ, Pikarsky, AJ, Efron, JE, Weiss, EG, Nogueras, JJ, Wexner, SD 2002Intraoperative endoscopy in laparoscopic colectomySurg Endosc16808811CrossRefPubMed
Metadata
Title
Intraoperative carbon dioxide colonoscopy: a safe insufflation alternative for locating colonic lesions during laparoscopic surgery
Authors
K. Nakajima
S. W. Lee
T. Sonoda
J. W. Milsom
Publication date
01-03-2005
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 3/2005
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-004-8915-9

Other articles of this Issue 3/2005

Surgical Endoscopy 3/2005 Go to the issue