Capnothorax during urologic laparoscopic surgery: A case report

Kim, Min Kyoung; Kang, Hyun; Baek, Chong Wha; Jung, Yong Hun; Woo, Young Cheol; Shin, Hwa Yong; Chang, In Ho

Case Report

General Article

Anesthesia and Pain Medicine 2014;9(1):73-76.
Published online January 30, 2014.

Capnothorax during urologic laparoscopic surgery: A case report

Min Kyoung Kim, Hyun Kang, Chong Wha Baek, Yong Hun Jung, Young Cheol Woo, Hwa Yong Shin, In Ho Chang

¹Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea. roman00@naver.com
²Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea.

Received: 22 October 2012 • Revised: 5 November 2012

Abstract

As the use of laparoscopy in urologic surgery gradually increase, the possibility of complication is also increasing. Pneumothorax from many complications is more likely to occur in the urologic surgery than other surgery. A 64-year-old male patient was admitted for laparoscopic multiple renal cysts marsupialization under general anesthesia. About 80 minutes after beginning the operation, the peak airway pressure was suddenly increased and the oxygen saturation was decreased. We suspected the pneumothorax based on decreasing breath sounds in the right chest area and checked for the diaphragmatic injury through communicating with surgeon. Positive end expiratory pressure and hyperventilation was applied to the patient. Surgeon sutured the diaphragmatic injure site, and the chest tube was placed. In conclusion, iatrogenic pneumothorax occurrence during the laparoscopic surgery can be early detected and treated through appropriate monitoring, risk awareness, and close communication with surgeon.

Key Words: Capnothorax, Laparoscopy, Pneumothorax, Urology