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Related Experiment Videos

Pneumothorax during laparoscopic Nissen fundoplication

D Mangar1, G T Kirchhoff, J J Leal

  • 1Department of Anesthesiology, Tampa General Hospital, Florida 33606.

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|September 1, 1994
PubMed
Summary

A 100% pneumothorax occurred during laparoscopic Nissen fundoplication. Early monitoring of oxygen saturation and airway pressures is crucial for diagnosing and treating this rare complication during minimally invasive surgery.

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Area of Science:

  • Anesthesiology
  • Thoracic Surgery
  • Gastroenterology

Background:

  • Laparoscopic Nissen fundoplication is a common procedure for gastroesophageal reflux disease.
  • Pneumothorax is a rare but serious complication that can occur during laparoscopic abdominal surgery.
  • This case highlights a significant pneumothorax during a standard laparoscopic procedure.

Observation:

  • A 41-year-old male developed a 100% left pneumothorax during laparoscopic Nissen fundoplication.
  • Intraoperative findings included increased peak inspiratory pressure, wheezing, decreased oxygen saturation, and an obstructive pattern on capnography.
  • Decreased breath sounds on the left and subsequent endotracheal tube repositioning were noted.

Findings:

  • Post-procedure chest roentgenogram confirmed a 100% left pneumothorax.

Related Experiment Videos

  • Placement of a left chest tube resulted in immediate improvement of oxygen saturation to 100%.

    • Implications:

    • This case underscores the importance of vigilant monitoring of oxygen saturation, peak inspiratory pressures, and chest excursion during laparoscopic procedures.
    • Prompt recognition and management are essential to prevent severe hypoxemia and ensure patient safety.
    • Consideration of pneumothorax should be included in the differential diagnosis for respiratory compromise during laparoscopic surgery.