Lap cholecystectomy
| Discussion in 'All Categories' started by Arundati Ramdas Raikar - Mar 6th, 2023 11:48 am. | |
Arundati Ramdas Raikar
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Sir, i completed my training in FMAS in Oct 2022, i did my independent first lap chole on March 6th 2023. All the things i learnt from the training helped me a lot. My patient has rt shoulder pain, is there a way to decrease this intraoperative? N there were stones in hartmans pouch because of which giving traction for dissection was very difficult. Is there a technique for such cases |
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re: Lap cholecystectomy
by Dr. R. K. Mishra -
Apr 15th, 2023
4:03 pm
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Dr. R. K. Mishra
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Shoulder pain after laparoscopic cholecystectomy is a common postoperative complaint and is thought to be caused by residual carbon dioxide (CO2) gas in the abdomen. During laparoscopic cholecystectomy, CO2 gas is used to inflate the abdomen, which can irritate the phrenic nerve and cause referred pain in the shoulder. There are several techniques that can be used to decrease the amount of CO2 gas in the abdomen during laparoscopic cholecystectomy, which may help to reduce shoulder pain. These techniques include: Reducing the intra-abdominal pressure: Lowering the pressure of the CO2 gas used to inflate the abdomen can help reduce the amount of gas that remains in the abdomen after surgery, which may help to decrease shoulder pain. Rapid evacuation of CO2 gas at the end of surgery: Quickly removing the CO2 gas from the abdomen at the end of the procedure may help to reduce the amount of gas that remains in the abdomen and decrease the likelihood of shoulder pain. Using warmed and humidified CO2 gas: The use of warmed and humidified CO2 gas during surgery may help reduce inflammation and irritation of the phrenic nerve, which can reduce shoulder pain. Positioning the patient correctly during surgery: Positioning the patient at a slight head-up tilt or in the left lateral decubitus position during surgery may help reduce the amount of CO2 gas that accumulates in the shoulder area. In summary, several techniques can be used to decrease the amount of CO2 gas in the abdomen during laparoscopic cholecystectomy, which may help reduce shoulder pain after surgery. These techniques include reducing the intra-abdominal pressure, rapid evacuation of CO2 gas at the end of surgery, using warmed and humidified CO2 gas, and positioning the patient correctly during surgery. |
