Pressure and Laparoscopic Surgery Part 1

Welcome to All Sensors “Put the Pressure on Us” blog. This blog brings out pressure sensor aspects in a variety of applications inspired by headlines, consumer and industry requirements, market research, government activities, and you.

Pressure and Laparoscopic Surgery Part 1

Getting room to operate with pressure

Laparoscopic surgery provides an alternative to more extensive open surgical procedures. Its benefits include reduced postoperative pain, reduced scarring and shorter hospital stays. Accessed by incisions through the stomach (abdominal wall), several procedures including appendectomies are routinely performed using laparoscopic surgery. Having adequate space to repair or remove the affected area is achieved by pumping (or insufflating) a gas, usually carbon dioxide (CO2), into the abdominal (or peritoneal) cavity to create a pneumoperitoneum (abnormal space).

Laparoscopic surgery showing a three-way valve in the gas line (arrow), gas return line (top right) scope (at navel) and operating device. 
Source: SemanticsScholar.org
Laparoscopic surgery showing a three-way valve in the gas line (arrow), gas return line (top right) scope (at navel) and operating device.
Source: SemanticsScholar.org

Pressure inside the abdominal compartment, the intra-abdominal pressure (IAP), is normally 0 to 5 mmHg but it can increase to 5 to 7 mmHg during a critical illness. For laparoscopic surgery, carbon dioxide is insufflated into the peritoneal cavity at a rate of 4–6 liter/min to a pressure usually between 12 and 15 mmHg but sometimes the range increases to between 10 to 20 mmHg. To keep this pressure steady, the pneumoperitoneum is maintained by a constant gas flow of 200–400 ml/min.

A high IAP is associated with postoperative problems, so researchers are investigating different techniques to provide alternative lower pressure recommendations for adequate work space instead of using the current, predetermined levels. One study found that the different approaches they tried resulted in an acceptable workspace at 8 mmHg IAP in 61 out of 78 patients.

For other pressures involved in laparoscopic surgery see Pressure and Laparoscopic Surgery Part 2.

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