Using And Controlling The Pneumo Sure Xl High Flow Insufflator In Bariatric Operating Mode; Device-Specific Dangers When Using The Pneumo Sure High Flow Insufflator In Bariatric Operating Mode - Stryker PNEUMO SURE Instrucciones De Uso

8 Using and Controlling the PNEUMO SURE XL High Flow In-
sufflator in Bariatric Operating Mode
Bariatric operating mode is used for laparoscopies performed on severely over-
2
weight (BMI > 30 kg/m ) adults. While in Bariatric mode, the insufflator limits
the pressure to max. 30 mm Hg and the gas flow to max. 45 l/min. This operating
mode delivers rapid insufflation of large volumes.
The device may not be used to fill an abdomen with CO2 if a laparoscopy is con-
traindicated. Please consult the manual of your laparoscope for absolute and rel-
ative contraindications. The device is not suitable for hysteroscopic insufflations,
i.e., it may not be used to distend the uterus.
The gas flow may not exceed 14 l/min when performing a laparoscopy on infants
or patients weighing less than 25 kilos.
8.1 Device-Specific Dangers when Using the PNEUMO SURE High
Flow Insufflator in Bariatric Operating Mode
WARNING!
Altered Respiratory Physiology
Always monitor the patient's respiratory functions during the entire surgery. The
larger body mass supported by the thoracic cage and the larger amount of fat in
the abdominal cavity may reduce the elasticity of the thoracic wall. In addition,
the increased intra-abdominal pressure secondary to insufflation may alter the
normal physiological lung parameters thus resulting in a reduction of the func-
tional lung volume. Shallow, rapid breathing is symptomatic of this condition.
Even modest physical stress causes a tremendous increased demand for oxygen,
which stands in contrast to the ineffective respiratory musculature that requires
more oxygen because it must overcome the reduced elasticity of the thoracic
cage. The functional capacity of the lungs is small and even moderate stress can
lead to respiratory failure.
WARNING!
Subcutaneous Emphysema
When puncturing the thicker abdominal wall of morbidly obese patients with
the Veress cannula or the trocar, carefully monitor the correct position of the in-
strument in the abdomen.
WARNING!
Idiosyncratic reactions
Patients with sickle cell anemia or pulmonary insufficiency may have a higher
risk of metabolic imbalance related to excessive CO
reaction).
WARNING!
CO absorption
2
CO is absorbed during insufflation (intravasation). This means the body absorbs
2
part of the CO gas used for insufflation. CO
2
spiratory system that are too high can lead to death of the patient in extreme
cases. To lower this risk, always carefully and closely monitor the patient's vital
signs during the entire insufflation process and make sure patient is breathing
well. Sufficient respiration can help avoid or limit problems with CO
sure or a high gas flow promotes CO
distended using a pressure between 10 to 15 mmHg. Pressure values above
15 mmHg are required for only a few cases but do increase the risk of intravasa-
tion. Never exceed the max. intra-abdominal pressure of 30 mmHg.

Using and Controlling the PNEUMO SURE XL High Flow Insufflator in Bariatric Operating Mode

absorption (idiosyncratic
2
concentrations in the blood or re-
2
absorption. The abdomen is sufficiently
2
Intended use
Contraindications
. High pres-
2
EN
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