Users Manual

Operating Modes of the PNEUMOCLEAR™ Insufflator
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WARNING!
Embolism/insufflation of internal organs
Improper placement of the insufflation instrument could cause gas penetrating a
vessel or an internal organ, resulting in air or CO
2
embolisms. To reduce the risk,
use a low flow rate for the first insufflation and ensure that the insufflation instru-
ment is correctly positioned. Check the position of the insufflation instrument im-
mediately if the actual pressure rapidly reaches the nominal pressure value. CO
2
embolisms can also be caused by a high intra-abdominal pressure. Avoid high-pres-
sure settings and close damaged blood vessels at once.
WARNING!
Emphysema
Incorrect placement of a cannula or a trocar into subcutaneous tissue may lead to
emphysema. To reduce the risk, use a low gas flow rate for the first insufflation and
ensure that the insufflation instrument is correctly positioned. Long surgeries
(> 200 min.), the use of many access points, duration and size of leaks at these
points may also contribute to emphysema. Be sure to close leakages in trocar ac-
cesses immediately.
WARNING!
Additional insufflation sources / automatic venting system
Make sure the automatic venting system is activated (see Chapter Menu (Over-
view) [} 51]). The use of additional insufflation sources increases the intra-ab-
dominal pressure. Continuously monitor intra-abdominal pressure over the course
of the entire insufflation if additional sources are used.
6.2 High Flow/Bariatric Operating Mode
The
High Flow/Bariatric
operating mode is used to distend the peritoneal cavity
during laparoscopic procedures by insufflating CO
2
. It features a constantly in-
creased performance to compensate port side leakages and continuing smoke
evacuation over the time of the procedure.
Patients
The
High Flow/Bariatric
operating mode is designed for laparoscopies performed
on normal weight and obese patients (BMI>30kg/m
2
) over the age of 14.
The High Flow/Bariatric operating mode may be used for a number of different
procedures, including but not limited to:
• weight loss surgery
• bowel resection
• colorectal surgery
Insufflation parameters
The maximum nominal pressure can be set to 30 mmHg and the maximum gas
flow to 45l/min.
WARNING!
Idiosyncratic reactions
Patients with sickle cell anemia or pulmonary insufficiency may have a higher risk
of metabolic imbalance related to excessive CO
2
absorption (idiosyncratic reaction).
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