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Heated insufflation with or without humidification for laparoscopic abdominal surgery
Daniel W Birch1, Jerry T Dang, Noah J Switzer
1Center for the Advancement of Minimally Invasive Surgery, Department of Surgery, University of Alberta, Royal Alexandra Hospital, Rm. 418 CSC, 10240 Kingsway Ave, Edmonton, AB, Canada, T5H 3V9.
The Cochrane Database of Systematic Reviews
|November 2, 2016
Summary
Heated gas insufflation in laparoscopic surgery does not significantly improve patient outcomes or core body temperature maintenance. This review found no clear evidence supporting its use over cold gas insufflation for better surgical results.
Area of Science:
- Anesthesiology
- Surgical Technology
- Patient Safety
Background:
- Intraoperative hypothermia is a risk in abdominal surgeries, both open and laparoscopic.
- Heated insufflation systems are used in laparoscopic surgery to prevent hypothermia, with potential for gas humidification.
- Previous studies on heated insufflation yielded inconclusive results regarding core temperature, pain, and recovery.
Purpose of the Study:
- To evaluate the impact of heated versus cold gas insufflation on maintaining intraoperative normothermia.
- To assess the effect of heated gas insufflation on patient outcomes after laparoscopic abdominal surgery.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searched multiple databases (Cochrane, MEDLINE, Embase, etc.) up to September 2016 for human studies.
- Included 22 RCTs (1428 participants) comparing heated (with/without humidification) vs. cold gas insufflation.
Main Results:
- Heated, humidified gas showed a mild increase in core temperature (0.31°C), but this was not clinically significant and heterogeneity was high.
- No significant differences were found in postoperative pain scores or length of hospital stay.
- Morphine use was higher in the heated, non-humidified group postoperatively; recovery room time was shorter but this finding was not robust.
- No differences in major adverse events or lens fogging were observed.
Conclusions:
- Despite a slight increase in core temperature, heated gas insufflation (with or without humidification) offers no clear clinical benefit over cold gas for laparoscopic abdominal surgery.
- The minor temperature changes are unlikely to translate into improved patient outcomes.
- Further research is needed, but current evidence does not support routine use of heated gas insufflation.
