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Related Concept Videos

Chronic Obstructive Pulmonary Disease II: Emphysema01:23

Chronic Obstructive Pulmonary Disease II: Emphysema

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Emphysema, a major phenotype of chronic obstructive pulmonary disease (COPD), is characterized by irreversible destruction of alveolar walls and permanent enlargement of distal airspaces. Unlike chronic bronchitis, which primarily affects the airways, emphysema predominantly involves the lung parenchyma, where structural damage leads to airflow limitation.PathophysiologyIt most commonly results from prolonged exposure to cigarette smoke and other toxic gases, particularly cigarette smoke.
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Pneumothorax-II01:27

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Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
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Pneumothorax II: Pathophysiology01:08

Pneumothorax II: Pathophysiology

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Pneumothorax means the presence of air in the pleural space — the thin potential gap between the visceral and parietal pleura. This condition disrupts the normal pressure balance that keeps the lungs inflated, leading to partial or complete collapse of the affected lung.Normal physiologyUnder normal conditions, the pleural space maintains a slightly negative intrapleural pressure, which keeps the lungs expanded against the chest wall. This negative pressure creates a delicate balance...
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Pneumothorax-I01:26

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A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
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Atelectasis II: Pathophysiology01:10

Atelectasis II: Pathophysiology

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Atelectasis develops when alveoli lose their air and collapse inward. Because lung tissue is naturally elastic, these air sacs shrink rather than remaining open. Collapsed alveoli are no longer ventilated, reducing their role in gas exchange. Blood flow may continue in these regions, creating a ventilation–perfusion mismatch. Clinical findings include decreased breath sounds, dullness to percussion, reduced chest expansion, and decreased tactile fremitus as sound transmission through...
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Pulmonary Embolism I: Introduction01:29

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Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
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Robotic-assisted Left Pneumonectomy For Vanishing Lung Syndrome
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Subcutaneous emphysema--beyond the pneumoperitoneum.

Douglas E Ott1

  • 1Biomedical Engineering, Mercer University, 109 Preston Court, Macon GA 31210, USA. gabiomed@mindspring.com.

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|April 1, 2014
PubMed
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).

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  • 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.