Insufflation

Using gas during a laparoscopic surgery

If you have been told that you are going to be pumped with gas (Insufflation) during your laparoscopic surgery, it’s only natural that you would want to know more about the process and how it can affect you.

What is Insufflation?

Insufflation is the process by which surgeons create more workroom within the body during a laparoscopic surgery. It involves the introduction of a gas into the peritoneal cavity (a potential space between the two membranes that keep the abdominal cavity’s organs apart from its wall).

Why is Insufflation necessary?

Your body contains almost no free space. Without adequate room to manoeuvre in, it can be quite difficult for Dr G to do a neat job that doesn’t interfere with the functioning of other organs. With the introduction of the appropriate amount of gas into your peritoneal cavity, the space available to Dr G increases sufficiently for him to perform the surgery with precision. In addition to providing more room, the increased space also facilitates clarity of vision.

How is Insufflation performed?

The insufflation gas is introduced into your body through a needle or a medical tool known as a trocar device. This causes the abdominal wall to inflate and separate from its organs. The delivery system that manages your distention comprises specialised equipment that monitors and ensures optimal pressure, volume, and temperature of the gas. At the end of the laparoscopic procedure, the gas is released from your body in a controlled manner. It can take several days before all traces of it disappear, however, and the residual gas can cause you certain discomfort.

Gases: Which ones and why?

Because it is non-flammable, colourless, and provides a significant margin of safety in the context of venous embolisms, carbon dioxide is used more frequently than any other gas for abdominal insufflation. It clears quickly from the human body and has high blood- and tissue-solubility.

Common side effects from the gas are:

• shoulder pressure
• neck and rib discomfort
• occasional chest discomfort

These effects usually settle spontaneously within a few days after the surgery.

Is Insufflation safe?

Several precautions are taken to ensure your safety. This includes the filtration of the insufflation gas to minimise contamination, the application of heat to minimise the risk of hypothermia, and hydration to maintain cellular integrity and reduce the formation of internal scar tissue (known as adhesions).

Like everything else, though, the process of insufflation can have adverse effects upon some people. Major complications include its effect upon the cardiovascular system. The problems that might arise in this context include tachycardia, greater cardiac contractility, and a decrease in diastolic filling. Minor complications include wound infections, herniation, and hematomas of the abdominal wall.

Since some people are more at risk than others, Dr G will explore all options with you in detail when determining the right methods to treat your problem.

Technical Terms