title: Impact of a warm gas insufflation on operating-room ergonometrics during laparoscopic gastric bypass: a pilot study.
abstract: BACKGROUND
  With the use of various laparoscopic instruments, the work of operating-room (OR) personnel has increased significantly. The impact of warm gas insufflation on the ergonometrics of the OR was studied, using one of the most involved laparoscopic surgical procedures, Roux-en-Y gastric bypass (RYGBP) for morbid obesity, to assess if use of warm gas insufflation decreases the work of the OR personnel.
  
  
  METHODS
  20 patients between August 2003 and January 2004 (6 months) were divided into 2 groups. 10 patients with age 50+/-10 years and BMI 48+/-8 underwent laparoscopic RYGBP using a warmed CO2 insufflator (WI). These results were compared to 10 patients with age 53+/-15 years and BMI 51+/-7 using a non-warmed CO2) insufflator (NWI). Total time of surgery (TOS), time spent cleaning the laparoscope (TCS), time spent changing warm saline (TWS), time spent using anti-fog (TAF), and time the circulating nurse was involved in these activities (TN) were compared. Statistical analysis used a two-sample, Student t-test with unequal variances.
  
  
  RESULTS
  The 2 bariatric populations were almost similar in age and BMI. TCS (P<0.0003), TWS (P<0.0001) and TN (P<0.0002) took significantly less time in the WI group, while TOS and TAF were similar.
  
  
  CONCLUSIONS
  Use of warmed CO2 insufflation had a significant impact on TCS, TWS and TN. This impacts the ergonometrics of the OR, allowing more time for the personnel and surgeons to concentrate on the surgery.
authors.affiliation: Texas Tech University Health Sciences Center, Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Lubbock, TX 79415, USA.
authors.forename: Alfonso Barnard
authors.initials: AB
authors.lastname: Barragan
authors.forename: Eldo Ermenegildo
authors.initials: EE
authors.lastname: Frezza
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002245:Carbon Dioxide / Q000494:pharmacology*; D016552:Ergometry; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D009873:Operating Rooms; D010865:Pilot Projects; D011028:Pneumoperitoneum, Artificial / Q000379:methods*; D011336:Probability; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D013696:Temperature; D016896:Treatment Outcome
chemical_list: D002245:Carbon Dioxide