Our Summary

This research paper compares two methods of maintaining pressure in the abdomen during a laparoscopic appendectomy (a minimally invasive surgery to remove the appendix) in children. The two methods are the conventional pneumoperitoneum (CP) and the AirSeal Intelligent Flow System (AiFS). The study looked at 39 children aged between 3 and 14 years who underwent this procedure.

The pressure in the abdomen during the insertion of surgical instruments was initially the same for both groups, but then reduced and maintained until the operation was completed. The study found that the average pressure in the abdomen, average systolic blood pressure (pressure in the arteries during heartbeats), and average end-tidal CO2 (amount of carbon dioxide at the end of an exhaled breath) were significantly lower in the AiFS group compared to the CP group.

However, other factors such as heart rate, oxygen levels in the blood, body temperature, urine output, operation time, blood loss, when the child could start eating again, and the length of hospital stay after surgery, were not significantly different between the two groups.

In simple terms, the study suggests that the AiFS method could lead to lower pressure in the abdomen, lower blood pressure, and lower levels of carbon dioxide during laparoscopic appendectomy in children, which could potentially improve patient outcomes.

FAQs

  1. What is the difference between Conventional pneumoperitoneum (CP) and automatically maintained pneumoperitoneum using AirSeal Intelligent Flow System (AiFS) during pediatric laparoscopic appendectomy?
  2. Were there significant differences in intraperitoneal pressure (IPP) and hemodynamic parameters between children who had laparoscopic appendectomy with CP versus AiFS?
  3. Does the use of AiFS in pediatric laparoscopic appendectomy affect postoperative hospitalization or recommencement of oral intake?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pediatric appendectomy is to ask about the use of an automatically maintained pneumoperitoneum system, such as the AirSeal Intelligent Flow System (AiFS). This system can help maintain lower intraperitoneal pressure during the procedure, which may lead to better hemodynamic stability and potentially a faster recovery. It’s important to discuss this option with your surgeon to see if it is available and appropriate for your child’s surgery.

Suitable For

Pediatric patients who require laparoscopic appendectomy are typically recommended for this procedure. In the study mentioned above, children aged 3-14 years who required a standard 3-trocar laparoscopic appendectomy were included. The study compared the use of conventional pneumoperitoneum versus automatically maintained pneumoperitoneum using the AirSeal Intelligent Flow System. The results showed that the use of the AirSeal system resulted in lower intraperitoneal pressure, which may be beneficial for pediatric patients undergoing laparoscopic appendectomy.

Timeline

Before pediatric appendectomy:

  • Patient experiences symptoms of appendicitis such as abdominal pain, fever, nausea, and vomiting
  • Patient undergoes physical examination and diagnostic tests (such as ultrasound or CT scan) to confirm appendicitis
  • Surgery is scheduled for pediatric laparoscopic appendectomy

After pediatric appendectomy:

  • Patient is taken to the operating room and undergoes laparoscopic appendectomy using either conventional pneumoperitoneum or automatically maintained pneumoperitoneum with AiFS
  • Intraoperative parameters such as intraperitoneal pressure, blood pressure, end-tidal CO2, pulse, oxygen saturation, body temperature, and urine output are monitored
  • Surgery is completed with minimal blood loss and a relatively short operative time
  • Patient is monitored postoperatively for complications and is allowed to resume oral intake within a day or two
  • Patient is discharged from the hospital after a few days of observation and recovery period

What to Ask Your Doctor

  1. What is the difference between conventional pneumoperitoneum and automatically maintained pneumoperitoneum using the AirSeal Intelligent Flow System?
  2. How does the intraperitoneal pressure during the surgery affect the patient’s overall health and recovery?
  3. What are the potential risks and benefits of using the AirSeal Intelligent Flow System for pediatric laparoscopic appendectomy?
  4. How does the use of the AirSeal Intelligent Flow System impact the duration of the surgery and the amount of blood loss?
  5. How does the lower intraperitoneal pressure during surgery with the AirSeal Intelligent Flow System affect the patient’s postoperative recovery and hospitalization time?
  6. What are the criteria for determining if a patient is a suitable candidate for using the AirSeal Intelligent Flow System during pediatric laparoscopic appendectomy?
  7. Are there any specific precautions or considerations that need to be taken when using the AirSeal Intelligent Flow System in pediatric patients?
  8. How does the use of the AirSeal Intelligent Flow System impact the patient’s pain levels and overall comfort during and after the surgery?
  9. What is the follow-up care like for patients who undergo pediatric laparoscopic appendectomy with the AirSeal Intelligent Flow System?
  10. Are there any long-term effects or implications of using the AirSeal Intelligent Flow System for pediatric laparoscopic appendectomy that I should be aware of?

Reference

Authors: Miyano G, Nakamura H, Seo S, Sueyoshi R, Okawada M, Doi T, Koga H, Lane GJ, Yamataka A. Journal: J Pediatr Surg. 2016 Dec;51(12):1949-1951. doi: 10.1016/j.jpedsurg.2016.09.016. Epub 2016 Sep 15. PMID: 28029370