E Laparoscopic urologic surgery
Laparoscopy is the process of inspecting the abdominal cavity through an endoscope. Some examples of surgical procedures that can be done laparoscopically include varicocelectomy, percutaneous stone retrieval, nephrectomy, transplants, and radical prostatectomy.
Carbon dioxide is used to insufflate the abdominal cavity to facilitate view during this procedure. Several pathophysiologic changes can occur after carbon dioxide pneumoperitoneum and extremes of patient positioning required for the procedure.
Unique problems specific to urologic surgery are listed below.
a) The urogenital system is a retroperitoneal system. As such, carbon dioxide insufflated in this space communicates freely with the thorax and subcutaneous tissue. Subcutaneous emphysema can occur and may extend to the head and neck. In severe cases, it may lead to submucous swelling and airway compromise in the unprotected airway.
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