GAS EMBOLISM DURING LAPAROSCOPY - A REPORT OF 7 CASES IN PATIENTS WITH PREVIOUS ABDOMINAL SURGICAL HISTORY

The use of laparoscopic surgery has grown considerably, and the occure nce of some accidents, albeit rare, is now reported. Among them, gas e mbolism can induce a bad postoperative outcome. We report seven cases of carbon dioxide embolism (CO2) during laparoscopic surgery, In the s even cases gas embolism occurred during insufflation or a few minutes later. All the patients had a previous abdominal or pelvic surgical hi story. Five patients presented cardiac bradycardia or arrhythmia. Card iovascular collapse or cyanosis was the first manifestation in three c ases. Sudden bilateral mydriasis was the earliest neurologic sign, pre sent in five cases. Finally, the gas embolism complication was lethal in two cases. In summary, this study strongly stresses the need for pr ecise rules of prevention of gas embolism, and close monitoring of car diac rhythm during insufflation of carbon dioxide. The patients who ha d previous surgery should be considered as a risk population.