Laparoscopic surgery, commonly called keyhole surgery, is now widely established as a way to minimise patient trauma. The benefits include reduced postoperative pain and scarring, short hospital stays, better patient satisfaction and a much quicker recovery time.

While commonly done for gynaecological and appendectomy procedures, the range of surgical techniques is increasing in complexity and now includes cholecystectomy (gall bladder), adrenalectomy (adrenal gland), nephrectomy (kidney removal), fundoplication (gastro-esophageal reflux), hernia repair and bowel resection procedures.

“Laparoscopy takes its name from the laparoscope, a slender tool that has a tiny video camera and light on its end,” explained Hans Strydom, Afrox’s Technical Services Manager as he talked to gasworld about laparoscopy and the use of the South African company’s high purity medical CO2 to enable surgeons to successfully complete surgical procedures that cause minimal trauma to patients.

“Surgeons insert it through a small cut into the patients’ body, which enables them to see the area of concern on a video monitor. They then insert laparoscopic surgical holding and cutting instruments such as forceps and scissors into separate small holes, which they can manipulate from outside the patient’s body to complete the procedure.”

“In most laparoscopic appendectomies, for example, surgeons operate through three small incisions of ¼ to ½-inch long, while watching an enlarged image of the patient’s internal organs on a television monitor.”

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In order to create space around the area of operation and to open a clear view of the surgical target, a medical gas is used to create an internal ‘gas bubble’ between the organ and its layers of protective tissues (peritonea).

“This ‘gas bubble’ is called the pneumoperitoneum and is typically formed by introducing CO2 into the cavity at a rate of 4 to 6 litres/min at pressures of 10 to 20 mm of Hg. The cavity is then maintained for the duration of the surgery by a constant gas flow of 200 to 400 ml/min,” Strydom continued.

“CO2 is preferred as the insufflation gas because it is non-flammable, colourless and has higher blood solubility than air. This reduces the risk of complications such as blood clots or embolisms following surgery.”

Afrox, through its Healthcare division, is committed to the best possible quality care and patient safety. “We have been pioneers of medical gas products for many years and we continue to be committed to working with healthcare providers and regulatory authorities to promote best practice use of our products.

“We have been supplying medical carbon dioxide to European Pharmacopeia standards for many decades to the southern African medical fraternity and are proud to have played a part in the development of modern medical techniques such as laparoscopic surgery,” Strydom concluded.