Surgical laparoscopy, endoscopy & percutaneous techniques
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Surg Laparosc Endosc Percutan Tech · Dec 2008
Review Meta AnalysisEffect of heated and humidified carbon dioxide on patients after laparoscopic procedures: a meta-analysis.
To systematically analyze the role of heated humidified carbon dioxide (CO2) in laparoscopy. ⋯ The use of heated humidified CO2 for pneumoperitoneum in laparoscopic procedures is associated with lesser postoperative pain, lower risk of postoperative hypothermia, and lower analgesic requirements. However, total hospital stay and lens fogging rates do not differ. Hence, the heated and humidified CO2 may be considered as the first choice for pneumoperitoneum in laparoscopic procedures.
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Surg Laparosc Endosc Percutan Tech · Dec 2008
Randomized Controlled TrialRoutine administration of antibiotics to patients suffering accidental gallbladder perforation during laparoscopic cholecystectomy is not necessary.
Accidental rupture of the gallbladder is an event which occurs in up to 20% of laparoscopic cholecystectomies, mainly in those where dissection is difficult, or during extraction when the gallbladder is withdrawn directly through the laparoscope port. It has been commonly assumed that contamination by bile in the abdominal cavity could be a cause of infection and lead to the formation of a residual abscess or even to surgical wound infection. It is common practice, therefore, for the surgeon to prescribe the application of an antibiotic at the moment when gallbladder perforation occurs. ⋯ Routine application of an antibiotic to patients experiencing accidental perforation of the gallbladder during laparoscopic cholecystectomy is not necessary. In the case of patients with diabetes mellitus, those who are older than 60, or who have an ASA classification of 3 or more, or if the operation itself is likely to last more than 70 minutes, the recommendation is to start antibiotic therapy in the preoperative phase immediately before surgery.