Surgery- MIS: Bariatric & Hernia

Question 1

Symptoms of vena cava compression in laparoscopic surgery

Answer 1

Rare due to monitoring for high intraabdominal pressure

Decreased venous return
Reduced CO
Reflexive ↑ HR

Question 2

Diagnosis: Laparoscopic surgery, Insufflation, bradycardia, AV block

Answer 2

Peritoneal Stretch receptor activation

Question 3

Systemic effects of insufflation in MIS surgery

Answer 3

Bradycardia, AV block, ↑ SVR, ↑ BP.
severe: asystole

↑ intraabdominal pressure –> peritoneal stretch receptors –> ↑ vagal tone and mechanical ↑ SVR

Question 4

Signs and Symptoms of CO2 gas embolization in MIS surgery

Answer 4

Insufflation needle in artery, vein, or organ.
End-organ infarction
Hypotension
Obstructive shock