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Updated: May 1, 2026

07:27
Robotic-assisted Left Pneumonectomy For Vanishing Lung Syndrome
Published on: January 23, 2026
592
Subcutaneous emphysema--beyond the pneumoperitoneum.
1Biomedical Engineering, Mercer University, 109 Preston Court, Macon GA 31210, USA. gabiomed@mindspring.com.
Summary
Subcutaneous emphysema during laparoscopy can be prevented by understanding known and new risk factors. Careful attention to cannula use, gas dynamics, and procedure length enhances patient safety in laparoscopic surgery.
Area of Science:
- Minimally Invasive Surgery
- Surgical Complications
- Laparoscopic Techniques
Background:
- Subcutaneous emphysema and gas extravasation outside the peritoneal cavity during laparoscopy can lead to complications.
- Understanding factors increasing subcutaneous emphysema risk is crucial for safe laparoscopic procedures.
Purpose of the Study:
- To review and identify known and novel risk factors associated with subcutaneous emphysema during laparoscopic surgery.
- To enhance patient safety by recognizing a comprehensive spectrum of risk factors.
Main Methods:
- A literature review was conducted.
- A PubMed search was performed to identify relevant studies.
Main Results:
- Known risk factors include multiple abdominal entry attempts, improper cannula placement, loose fittings, >5 cannulas, cannula fulcrum use, laparoscope torque, high intra-abdominal pressure, and long procedures (>3.5 hours).
- Novel risk factors identified are total gas volume, gas flow rate, valveless trocar systems, and robotic fulcrum forces.
Conclusions:
- Recognizing a wide range of factors, from procedural techniques to gas delivery systems, is essential for preventing subcutaneous emphysema.
- Implementing this knowledge will improve patient safety during laparoscopic interventions.
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