• V R Jacobs, J E Morrison, L Mettler, C Mundhenke, and W Jonat.
• Department of Surgery, Fayette Medical Center, Alabama, USA.
• J Am Assoc Gynecol Laparosc. 1999 Aug 1;6(3):289-95.

Study ObjectiveTo evaluate intraabdominal CO(2) temperature during a variety of standard operative laparoscopy procedures with different insufflators (BEI Medical, Snowden & Pencer, Storz Laparoflator, Storz Endoflator, Wolf) and devices to maintain body temperature (Bair Hugger, fluid warmer, Blanketrol blankets).DesignProspective, nonrandomized study (Canadian Task Force classification II-1).SettingCommunity hospital in rural Alabama.PatientsSixty-two consecutive patients (53 women, 9 men; average age 56.8 yrs, range 21-94 yrs).InterventionsPatients underwent standard laparoscopic and pelviscopic procedures during which intraoperative temperature changes in the insufflation system, abdomen, and rectum were measured.Measurements And Main ResultsCarbon dioxide was at room temperature in the insufflation hose ( approximately 23 degrees C). During insufflation, intraabdominal gas temperature decreased to as much as 27.7 degrees C (average 32.7 degrees C) depending on length of operation (23 min-5 hrs 8 min), amount of gas used (12.8-801 L), gas flow (up to 20 L/min), and leakage rate. Preoperative and postoperative temperature comparisons showed no decline in rectal temperature (average +0.18 degrees C) because warming equipment was sufficient.ConclusionThe decrease in intraoperative intraabdominal gas temperature is remarkable and can potentially harm the patient. It can be limited by restricting gas flow and leakage. In operations longer than 1 hour, substantial core body temperature drop should be prevented with appropriate heating and hydration devices. An insufflator with internal gas heating (Snowden & Pencer) had no significant clinical effect. (J Am Assoc Gynecol Laparosc 6(3):289-295, 1999)

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