Igwe, Patrick O.; Chuaken, Chula1
Colorectal and Minimal Access, General Surgery Unit, Department of Surgery, University of Port Harcourt Teaching Hospital (UPTH) and Immaculate Conception Endoscopy and Minimal Access Surgery (ICE MASS) Clinic, Ozuoba
1College of Health Science, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
Background: The use of carbon dioxide insufflation is the ideal method in achieving pneumoperitoneum or capnoperitoneum during laparoscopic surgery. The insufflator is also used to monitor abdominal pressure. Occasionally, failure or faulty insufflation may occur, hence leading to conversion.
Aim: We present the use of nebulizer to archive and maintain pneumoperitoneum and the use of mercury manometer to monitor the intra-abdominal pressure especially in the failure of routine methods.
Materials and Methods: Laparoscopic surgeries performed om January to May 2022 were included; ethical approval and informed consent were obtained. Five cases of laparoscopic cholecystectomies were performed using Onms 25-L insufflator; the same time a mercury manometer was connected in another 5 mm port. Insufflator and mercury manometer pressures were recorded at the same time. Capnography was routinely performed.
Results: The intra-abdominal pressure was maintained within 8–14 mmHg using the mercury manometer and room air nebulizer insufflation. The same abdominal pressure was recorded in insufflator and the mercury manometer. A room air nebulizer was also maintained in the intra-abdominal pressure with good outcome.
Conclusions: The use of nebulizer and mercury or digital manometer prevented conversion to open surgery by providing alternative monitoring with the same reliable method of capnoperitoneum during laparoscopy. A more randomized control trial is ongoing and will provide better information in this regard.
Keywords: Intra-abdominal pressure, mercury manometer, nebulizer© 2022 NIGERIAN JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY | Published by Wolters Kluwer – Medknow