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Re: Trauma of vessels during laporoscopy From: Bernard Cristalli (bcrist@club-internet.fr) Sat Dec 26 12:34:36 1998 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Bernard Cristalli: "Re: Hasson versus Veress insufflation." Previous message: Peter Wein: "Re: RCT supports expectant management 42 wks" Maybe in reply to: Lev Dubovoy, MD: "Trauma of vessels during laporoscopy" Next in thread: Gail Waldby: "Re: Trauma of vessels during laporoscopy" razvan Socolov a écrit: > Dear Colleagues and co-listers, > > May I add a humble opinion, as resulted from a 3-month period spent in an experienced service in Middlesbrough, UK > (South Cleveland Hosp, WEL Foundation Clinic), under the supervision of Mr. Ray Garry, maybe known by some of you. > > The recommendation he made, and applies to everyday interventions, is: > 1. insert Veress needle under 90 dgr. Not 45 dgr., as this will bring you in the extra-peritoneal space, resulting in emphysema, etc. --IMHO an emphysema is more begnine than an aortic wound. > 2. inflate at 25 mm Hg the peritoneum. In his large series, published also in an UK journal (I will look for the data) they made a study to assess the distance betwwen > the adominal wall and spine at different intra-abdominal pressures; it raises from 3-4 cm at 12 mmHg to 7-8 cm at 25 mmHg. --The point stands before the insertion of the 10 mm trocar. In a normal patient the anterior aotic wall is 4-5 cms below the umbilicus if the belly's empty. Once inflated the problem is less acute. > ... > > How's that for a decalogue? Please comment on that, as they convinced me (endoctrinated?) on their safe techniques. > > And Merry Christmas to you all, and a new year with lots of good dids! > > Dr. Razvan Socolov > Assist. Obstet. Gynaec. > Hospital "Elena Doamna", > 49 E. Doamna street, Iasi, Romania -- Bernard Cristalli MD CNGOF AIHP - ACCA Paris - France http://www.obgyn.net/corresp/cristalli.htm http://www.cliniquedelessonne.fr/ Next message: Bernard Cristalli: "Re: Hasson versus Veress insufflation." Previous message: Peter Wein: "Re: RCT supports expectant management 42 wks" Maybe in reply to: Lev Dubovoy, MD: "Trauma of vessels during laporoscopy" Next in thread: Gail Waldby: "Re: Trauma of vessels during laporoscopy"

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