Anaesthesia for gasless laparoscopy: our experience

Abstract

Summary The development of minimally invasive surgery has revolutionized surgical procedure with its attendant influence on anesthetic practice. These innovations carry potential risks to the patients, and the anesthetist’s ability to recognize and harness these challenges to ensure the safety of the patient and the comfort of the surgeon is plausible and an acceptable norm. Thirteen gynecological cases were selected for demonstration at the University College Hospital Ibadan between 6/11/07 to 15/11/07. All selected patients were American Society of Anesthesiologists (ASA) physical status 1 and 2 and were scheduled for the operation. The procedure was duly discussed with the patients and consents for both general anesthesia and the procedure were obtained. General anesthesia with endotracheal intubation and muscle relaxant technique was preferred and used in all the patients. The following monitoring parameters were utilized; Electrocardiogram (ECG); Non invasive blood pressure (NIBP); pulse oximeter, end tidal C02 (ETCO2); temperature; both peripheral and core (hypo pharyngeal) and the patients were mechanically ventilated using the Drager anesthetic machine with circle breathing systems. Surgery comprised of three diagnostic procedures (3) 23.0%, (adnexal mass (1) -chronic pelvic pain (2)), four hysterectomies 30.8% for dysfunctional uterine, bleeding, myomectomy (4) 30 .0%, Ovarian Cystectomy (2) 15.4%. We had the privilege to conduct anesthesia for Lift (Gasless) Laparoscopic surgery at the University College Hospital (UCH) Ibadan and would like to share pertinent issues relevant to anesthesia and about this novel technique.