The Only Clinically Proven Method for Conditioning CO2 Insufflation Gas to Improve Laparoscopic Patient Care. The Device that Delivers Benefits.
A synopsis of over 45 clinical studies are available upon request by contacting customer service at 877-9-LEXION or customerservice@lexionmedical.com
Reduction of Laparoscopic-Induced Hypothermia, Postoperative Pain and Recovery Room Length of Stay by Pre-Conditioning Gas with the Insuflow® Device: A Prospective Randomized Controlled Multi-Center Study
Ott D, Reich H, Love B, McCorvey R, Toldedo A, Liu C, Syed R, Kumar K. JSLS 1998; 2:321-329
Conclusion: Pre-conditioning laparoscopic gas by filtering heating and hydrating with the Insuflow® device was significantly more effective than the currently used standard raw gas and was safe in reducing or eliminating laparoscopic-induced hypothermia, shortening recovery room length of stay and reducing postoperative pain.
Improvement of Clinical Outcomes for Laparoscopic Gastric Banding Patients by Using the Insuflow® Pre-Conditioning Gas Device for the Pneumoperitoneum
Benavides R, Powell R, Wong A, Nguyen H., as given at ASBS, 2006, in publication.
Conclusion: Changing the quality of gas insufflation to a normal homeostatic physiologic environment using the Insuflow® device reduces shoulder pain, shortens recovery room length of stay and decreases pain medication requirements up to ten days postoperatively in laparoscopic gastric banding patients. Heated dry gas may cause additional complications due to the increase in pain medication and pain intensity.
Optimal Warming Technique for Major Laparoscopic Surgery: Forced Air Warming or Warmed and Humidified Insufflation Gas
Hamza M, Ogunnaike B, Provost D, White P. Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, TX.
Conclusion: The Insuflow® improved pain control and reduced the need for opioid analgesics and antiemetics in the postoperative period.
Decreased Incidence of Hypothermia and Peritoneal Irritation in Laparoscopic Donor Nephrectomy Using a Filter-Hydrator-Heating Device (Insuflow®)
Kandaswamy R, Gillingham K, Harmon J, Asolati M. Department of Surgery, University of Minnesota.
Abstract: Insuflow® patients spent less time in the recovery room (94 vs. 140 minutes), had decreased incidence of shoulder pain (0% vs. 40%) and shivering (0% vs. 40%). At the end of the procedure 70% of the non- Insuflow® patients were hypothermic compared to none in the Insuflow® group.
A Randomized Controlled Trial Assessing the Benefit of Humidified Insufflation Gas During Laparoscopic Surgery
Mouton W, Bessell J, Millard S, Baxter P, Maddern G. Surgical Endosc, 1999; 13:106-108
Conclusion: The use of humidified insufflation gas reduces postoperative pain following laparoscopic cholecystectomy.
Severe Local Hypothermia from Laparoscopic Gas Evaporative Jet Cooling: A Mechanism To Explain Clinical Observations
Gray R, Ott D, Henderson A, Cochran S, Roth E. JSLS 1999; 3:171-177
Conclusion: Evaporative cooling accounts for significant hypothermia. The cooling is dependent on the lack of water vapor in the gases currently used during laparoscopy. Cooling rates are independant of height from tissue and geometry of delivery port. Heating and hydrating the gas to a physiologic condition eliminates hypothermia and tissue desiccation.
Awake Microlaparoscopy with the Insuflow® Device
Almeida O. JSLS 2002; 6:199-201
Conclusion: Heating and humidifying the carbon dioxide gas produced fewer patient complaints of shoulder pain and shivering and decreased fogging of the microlaparoscope lens compared with procedures done with dry carbon dioxide during awake microlaparoscopic procedures.
Maintenance of Cell Viability at Laparoscopy by Hydration of CO2
Garner R, Wright E, Ott D. J Am Assoc Gynecol Laparosc 7(35):519, 2000
Results: Viability of cells exposed to unconditioned CO2 showed significant percentage of death attributable to desiccation at 4- to 5-minute exposure. Cells exposed to CO2 containing 75% or 95% humidity showed sustained viability even after 20 minutes exposure.
Conclusion: These data demonstrate the importance of modifying CO2 by heating and hydration to reduce cellular stress, reduce desiccation, and prevent cell death.
Model to Determine Resistance and Leakage-Dependent Flow on Flow Performance of Laparoscopic Insufflators to Predict Gas Flow Rate of Cannulas
Jacobs R, Morrison J, Mundhenke C, Golombeck K, Jonat W, Harder D. J Am Assoc Gynecol Laparosc, Vol. 7(3):331-337, 2000
Discussion: Gas directed at high flow through small diameters against tissue can dry out tissue, causing laparoscopic hypothermia and potential tissue damage.
Results: Hypothermia can and should be prevented with adequate gas hydration and warming devices.
Heated and Humidified Insufflation During Laproscopic Gastric Bypass Surgery: Effect on Temperature, Postoperative Pain, and Recovery Outcomes
Hamza M, Schneider B, White P, Recart A, Villegas L, Ogunnaike B, Provost D, Jones D. J Laparoendosc Adv Surg Tech 2005, 15(1):6-12
Results: Use of the Insuflow® device had 1) statistically significant higher intraoperative core body temperature, 2) no postoperative shivering, 3) less postoperative morphine analgesia, and 4) a higher quality of recovery by postoperative day two.
Impact of Temperature and Humidity of Carbon Dioxide Pneumoperitoneum on Body Temperature and Peritoneal Morphology
Hazebroek E, Schreve M, Visser P, DeBruin R, Marquet R, Bonjer J. Journal of Laparoendoscopic & Advanced Surgical Techniques, Vol. 12, No. 5, 2002, 355-364
Conclusion: Hypothermia can be prevented by both heating and humidifying the insufflation gas.
The Effect of Heating and Humidifying Gas on Patients Undergoing Awake Laparoscopy
Demco L. J Am Assoc Gynecol Laparosc 8(2):247-251, 2001
Conclusion: Heating and humidifying CO2 increases patient tolerance during awake laparoscopy using local anesthesia, decreases the frequency and duration of shoulder pain, shortens recovery time, and improves safety of the procedure.
Mild Intraoperative Hypothermia Prolongs
Postanesthetic Recovery
Lenhardt R, Marker E, Goll V, Tschernich H, Kurz A, Sessler D, Narzt
E, Lackner F. Anesthesiology 1997 Dec; 87(6):1318-1323
Conclusion: Maintaining core normothermia decreases the duration of postanesthetic recovery and may, therefore, reduce costs of care.
Influence of Gas Temperature During
Laparoscopic Procedures
Bessell J, Maddern G. The Pathophysiology of Pneumoperitoneum, Springer,
1998, Rosenthal R, Friedman R, Phillips E, editors. Chapter 3, 18-27
The nature of insufflation gas plays a substantial role in the development or prevention of hypothermia during laparoscopy. Hypothermia causes increased susceptibility to infection, induces hypokalemia, impairs myocardial function, depresses respiratory function, negative nitrogen balance, thromobocytopenia and depletes clotting factors. There is a financial penalty in increased recovery room length of stay. The degree of cooling is dependent on flow rate and extraction rate. The uncorrected physiologic insult of hypothermia is a problem of considerable magnitude. Cold or warm dry gas showed no significant temperature difference. Humidification of insufflated CO2 would largely resolve the problem of laparoscopic-induced hypothermia. The temperature drop is due to the latent heat of evaporation of body water to saturate the dry CO2gas. The use of warmed, humidified gas to maintain temperature homeostasis during laparoscopy must be advocated.
Peritoneal Surgery
di Zerega G. Some exerts from the foreword by Victor Gomel, Springer, 2000
This book is a summary of both the science of peritoneal repair and a manual of surgical techniques directed to the reduction of postsurgical adhesion and consequently improved surgical outcome. Postoperative adhesions may cause abdominal and pelvic pain, bowel obstruction and infertility. Desiccation of peritoneal cells, even from exposure to the atmosphere and lights of the operating room, may be sufficient to cause adhesions.
Laparoscopic gas can cause peritoneal drying. This concept demands respect for peritoneal surfaces. Every effort must be made not to damage the peritoneum. To avoid desiccation, the peritoneum must be kept moistened at all times. Operating within a closed peritoneal cavity largely prevents desiccation of the peritoneal surface, especially if the insufflation gas has been moistened and warmed to body temperature.
