Subcutaneous Emphysema and Pneumomediastinum during Laparoscopic Burch Operation.
10.4097/kjae.1997.32.3.467
- Author:
Mi Kyung YANG
1
;
Jung Sook HONG
;
Byung Dal LEE
;
Baek Hyo SHIN
Author Information
1. Department of Anesthesiology, Samsung Medical Center, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Carbon dioxide;
hypercarbia;
Complications;
pneumomediastinum;
subcutaneous emphysema;
Surgery;
extraperitoneal;
laparoscopy;
urologic
- MeSH:
Anoxia;
Carbon Dioxide;
Diagnosis;
Humans;
Insufflation;
Laparoscopy;
Mediastinal Emphysema*;
Palpation;
Subcutaneous Emphysema*;
Thoracic Wall;
Urinary Incontinence;
Ventilation
- From:Korean Journal of Anesthesiology
1997;32(3):467-472
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Laparoscopic Burch operation is one of laparoscopic surgery for stress urinary incontinence. Subcutaneous emphysema and hypercarbia are potential complications of laparoscopic surgery, but are more likely to occur in extraperitoneal surgery than in intraperitoneal surgery, since insufflated CO2 can diffuse easily into the surrounding tissues. We report a patient in whom pneumomediastinum and extensive subcutaneous emphysema developed during laparoscopic Burch operation. Transient hypoxemia was also accompanied with hypercarbia. Possible mechanisms are presented, along with discussion of prompt diagnosis and treatment. For the management of laparoscopic extraperitoneal surgery, it is necessary to be careful with monitoring of CO2 insufflation pressure, routine examination and palpation of chest wall, use of N2O with caution, increase of ventilation to eliminate CO2, and excluding other causes of subcutaneous emphysema and hypercarbia.
