Argon gas embolism in the application of laparoscopic microwave coagulation therapy.
BACKGROUND
A major concern in the use of the argon beam coagulator system is the potential risk of argon gas embolism.


METHODS
Seven cases with argon gas embolism in the English literature were reviewed along with the current case. The latter case was a 77-year-old female having laparoscopic hepatectomy after application of the microwave coagulation system on the cutting planes.


RESULTS
Immediately following shots of an argon beam to control local bleeding at the needle hole in the liver caused by microwave coagulation, the end-tidal carbon disappeared, followed by cardiovascular collapse. After 18 min of cardiovascular resuscitation, the tumors were resected under laparotomy.


CONCLUSIONS
After reviewing the cases, pneumoperitoneum (57.1%), hepatic needle punctures (42.8%) and direct application of the argon beam to the liver (28.6%) can be considered as risky processes in such events. Caution is necessary in the use of an argon beam in liver surgery to avoid life-threatening gas embolism.
Ikegami
Toru
T
Department of Surgery, The University of Tokushima, 3-18-15, Kuramoto-cho, Tokushima, 770-8503, Japan. tikesurg@yahoo.co.jp
Shimada
Mitsuo
M
Imura
Satoru
S
Nakamura
Tomoka
T
Kawahito
Shinji
S
Morine
Yuji
Y
Kanemura
Hirofumi
H
Hanaoka
Jun
J
D000368:Aged; D001128:Argon / Q000009:adverse effects*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D004618:Embolism, Air / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006488:Hemostasis, Surgical / Q000009:adverse effects; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D017075:Laser Coagulation / Q000009:adverse effects*; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects / Q000379:methods; D018570:Risk Assessment; D016896:Treatment Outcome
D001128:Argon