Pneumothorax: Laparoscopic Intraoperative Management During Fundoplication Facilitates Management of Cardiopulmonary Instability and Surgical Exposure

J Laparoendosc Adv Surg Tech A. 2018 Nov;28(11):1371-1373. doi: 10.1089/lap.2018.0050. Epub 2018 Jun 29.

Abstract

Introduction: Intraoperative pneumothorax may complicate surgery by obscuring surgical view and cause cardiorespiratory instability during fundoplication with large hiatus hernia. Proactive intraoperative treatment may reduce conversion and drain insertion and facilitate timely completion of surgery.

Materials and methods: The authors present effective surgical and anesthetic measures to alleviate pneumothorax, which are helpful for hemodynamic stability and surgical visibility.

Conclusion: Pneumothorax can complicate surgery by reducing surgical vision and causing cardiorespiratory instability. There is no requirement for laparoscopic or intercostal drainage. The authors provide various techniques to control intraoperative pneumothorax.

Keywords: fundoplication; hiatus hernia; pneumothorax; repair.

MeSH terms

  • Fundoplication / adverse effects
  • Fundoplication / methods*
  • Gastroesophageal Reflux / surgery
  • Hemodynamics
  • Hernia, Hiatal / surgery*
  • Humans
  • Intraoperative Complications / prevention & control
  • Intraoperative Complications / surgery*
  • Laparoscopy / methods*
  • Pneumothorax / etiology
  • Pneumothorax / surgery*
  • Respiration Disorders / prevention & control