[Effects of carbon monoxide produced during laparoscopic surgery]

One of the complications of laparoscopic surgery is carbon monoxide (CO) production under the use of electro-cautery. We studied 11 patients undergoing laparoscopic urological surgery. The concentrations of CO in peritoneal cavity and carboxyhemoglobin (HbCO) in arterial blood were measured before the operation under laparoscopy, during the use of electro-cautery and after the operation. The concentration of CO in peritoneal cavity reached 78 ppm during the use of electro-cautery but the HbCO level was unchanged. In the study on laparoscopic cholecystectomy (LC) performed previously, we had found no change of HbCO. The increase of CO on LC was more pronounced than in the present study. The concentration of CO in peritoneal cavity might be more dependent on the intensive use of electro-cautery than on operation time. Additionally the frequency of the insertion and extraction of the instruments through the trocar could have influenced it. CO could also be produced in the carbon dioxide cylinder. It should be investigated since it might contaminate the operating room.