Laparoscopic intragastric surgery under carbon dioxide pneumostomach.

ABSTRACT Background: Laparoscopic intragastric surgery (LIGS) requires a “pneumostomach,” which is created by air insufflation via gastroscopy. If the procedure is done without duodenal clamping, migrated air from the stomach causes excessive, prolonged bowel distention, which may lead to drawbacks during and after the operation. Carbon dioxide (CO2), with its faster absorption than air, can attenuate bowel distention when used to establish the pneumostomach. The aims of this study were to evaluate feasibility, safety, and effectiveness of the CO2 pneumostomach in LIGS. Methods: We have performed 15 LIGSs under the CO2 pneumostomach (January 1997 to August 2004). The stomach was insufflated with CO2 through an automatic surgical insufflator up to 8 mm Hg of intraluminal pressure. Neither a duodenal clamp nor an occlusion was employed prior to insufflation. Cardiopulmonary parameters were prospectively registered and retrospectively analyzed. The degree and extent of bowel distention was assessed by a conc...