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Surgical Endoscopy

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01-01-2017 | Review

Warmed and humidified carbon dioxide for abdominal laparoscopic surgery: meta-analysis of the current literature

Authors: David Balayssac, Bruno Pereira, Jean-Etienne Bazin, Bertrand Le Roy, Denis Pezet, Johan Gagnière

Published in: Surgical Endoscopy | Issue 1/2017

Abstract

Background

The creation of a pneumoperitoneum for laparoscopic surgery is performed by the insufflation of carbon dioxide (CO₂). The insufflated CO₂ is generally at room temperature (20–25 °C) and dry (0–5 % relative humidity). However, these physical characteristics could lead to alterations of the peritoneal cavity, leading to operative and postoperative complications. Warming and humidifying the insufflated gas has been proposed to reduce the iatrogenic effects of laparoscopic surgery, such as pain, hypothermia and peritoneal alterations. Two medical devices are currently available for laparoscopic surgery with warm and humidified CO₂.

Methods

Clinical studies were identified by searching PubMed with keywords relating to humidified and warmed CO₂ for laparoscopic procedures. Analysis of the literature focused on postoperative pain, analgesic consumption, duration of hospital stay and convalescence, surgical techniques and hypothermia.

Results

Bibliographic analyses reported 114 publications from 1977 to 2015, with only 17 publications of clinical interest. The main disciplines focused on were gynaecological and digestive surgery ). Analysis of the studies selected reported only a small beneficial effect of warmed and humidified laparoscopy compared to standard laparoscopy on immediate postoperative pain and per procedure hypothermia. No difference was observed for later postoperative shoulder pain, morphine equivalent daily doses, postoperative body core temperature, recovery room and hospital length of stay, lens fogging and procedure duration.

Conclusions

Only few beneficial effects on immediate postoperative pain and core temperature have been identified in this meta-analysis. Although more studies are probably needed to close the debate on the real impact of warmed and humidified CO₂ for laparoscopic procedures.

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Title: Warmed and humidified carbon dioxide for abdominal laparoscopic surgery: meta-analysis of the current literature
Authors: David Balayssac
Bruno Pereira
Jean-Etienne Bazin
Bertrand Le Roy
Denis Pezet
Johan Gagnière
Publication date: 01-01-2017
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 1/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-016-4866-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Warmed and humidified carbon dioxide for abdominal laparoscopic surgery: meta-analysis of the current literature

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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