General Surgery/Co2

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Question
QUESTION: Thank you for taking the time to help! My question is: A) Is it standard medical practice to remove the Co2 gas from the abdomen after a laparoscopic surgery (specifically robotic pyeloplasty)and B) If not, are there ways to determine if the Co2 was removed or left in? Thank you greatly!

ANSWER: Dear Rebecca,

Following laparoscopic surgery, the trochanters are removed and the abdomen is compressed by the surgeon and the assistant. The gas escapes through the small incisions made for the trochanter insertions. This helps to get most of the gas out of the peritoneal cavity. There will usually be gas left over which causes shoulder pain. Eventually the gas will dissipate and the pain resolves.

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QUESTION: I've read all over the internet that it could take one to four days for the Co2 to absorb- however, I experienced the gas in my abdominal cavity for ten days- very painful. A)Is this ten day time frame common? and B) They insufflated my abdomen to a pressure of 15, I experienced bradycardia, they deflated me and then re-insufflated me to a pressure of 12. Could this cause the lingering gas? and C) I am a small woman...Do medical professionals take patient size into account when they insufflate an abdomen...Is there a standard pressure for everyone or does it depend on body size or other factors? Thank you so much for your time!

Answer
Dear Rebecca,

You may be experiencing gas in the large intestine. Using a glycerine suppository will help to pass the gas. The large intestine produces pain when it is expanded. Gas is the number one reason. Carbon dioxide in the abdominal cavity is decreased significantly after the sugery is completed and before closing the incisions.  

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Dr. Pamela M. Cipriano, DNP, ACNP-BC

Expertise

GENERAL SURGERY Intestinal obstructions; Perforations; Ostomy; End ileostomy; Hemicolectomy; Take down ileostomy; Ostomy reversals; Diverticulitis; Chrohns Disease; Appendectomy; Cholecystectomy (gallbladder); Ventral hernia repair; Inguinal hernia repair; Umbilical hernia repair; Chest tubes; Pleurex catheters; Lobe-ectomy; Pneumonectomy; Thoracotomy; Pleuradesis; Thyroid surgery; Mastectomy; Lumpectomy LAPAROSCOPIC - LAPAROTOMY - LAPAROSCOPIC ASSISTED

Experience

My name is Dr. Cipriano. I am a Hospitalist on the Medical Staff. I round, admit, discharge, consult and assist with surgeries in the OR. I manage patients in the ICU and Med/Surg floors. I also work in the emergency department. I am certified critical care nurse (CCRN). And ACLS certified. I

Organizations
Society of Hospital Medicine American College of Nurse Practitioners Connecticut Advance Practice Registered Nurse Society

Education/Credentials
Maryville University 2014-2016 Doctor of Nursing Practice University of Connecticut 2007-2011 MSN, Acute Care Track Nurse Practitioner. Board Certified September 2011 Central Connecticut State University 2002-2006 BA Psychology St. Mary's Hospital School of Nursing 1991-1993 Diploma Nursing Registered Nurse

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