Future Questions
This review article has covered why the pneumoperitoneum, unique to
laparoscopy, can cause life threatening complications. Pneumoperitoneum
physiology, common reasons for cardiovascular collapse on insufflation
and their respective management have been covered. However, there are a
few questions that remain to be addressed in relation to this topic. 1)
If a vagal response or small carbon dioxide embolism is successfully
managed if and when should re-insufflation be attempted. How much slower
a rate of insufflation and pressure should be used? 2) What is the
safest entry into the abdominal cavity to allow insufflation. A Cochrane
review has tried to address this issue and even a recent update to that
review has still shown inconclusive
results12.