Noninvasive High Quality Monitoring during Laparoscopic Surgery

High quality monitoring during laparoscopic surgery with CNAP 

Medical Need:

The number of laparoscopic surgeries and the extent to which they are performed, has been increasing since the late 1980s. According to the U.S. Food and Drug Administration (FDA) more than 2 million laparoscopic procedures are performed in the United States each year - i.e. about 85% of all Cholecystectomies.

 

Because laparoscopic surgery may involve extreme changes in the patients’ position, extensive periods of intra-abdominal carbon dioxide (CO2) insufflation, and difficulty in evaluating the amount of blood loss, anesthesia for laparoscopy is considered a potentially high-risk procedure.

 

Same as laparoscopic surgery, also urological and gynecological surgeries are procedures that are mostly affected with unstable patient`s hemodynamics, that makes the maintenance of normotension critical.[1]

 

Since these procedures may induce serious physiological changes and complications, adequate monitoring must be applied to patients.

 

 

Solution:

CNAP® HD and the CNAP® technology improve quality and safety for patients undergoing laparoscopic intervention and provide the anesthesiologist with a wider scope of action through noninvasive, continuous blood pressure monitoring and the possibility for noninvasive hemodynamic optimization (goal-directed therapy with PPV/SVV and CO).

 

 

Medical Benefits:

  • CNAP® enables a rapid response to changes in blood pressure to better manage patients.
  • CNAP® PPV/SVV (Pulse Pressure Variation/Stroke Volume Variation) and CNAP® CO allow for noninvasive hemodynamic monitoring and fluid optimization with the same accuracy as invasive standards.[4,5]
  • Comfort for patients: noninvasive, thus safe monitoring whilst avoiding the risks of infection of invasive arterial lines
  • Easy to use: quick and error-free application for everyday use with minimal training required (applicable by every healthcare professional)
  • Fixed start-up-time of appr. 2 minutes
  • Reliable, noninvasive measurement where invasive arterial lines are not indicated.

 

 

Economic Aspects:

  • Hemodynamic management and goal directed therapy during anesthesia reduce hospital and ICU days.[2,3]
  • CNAP® HD helps avoiding follow-up cost due to infection or other intra-operative complications caused by invasive methods.
  • CNAP® HD is time saving: setup can be carried out by any healthcare professional, continuous values only shortly after startup
  • CNAP® HD requires minimal training
  • CNAP® HD saves cost as it works with reusable sensors

 

 

Case Reports

Laparoscopic Cholecystectomy in Obese Patient

CNAP® Monitoring during Cholecystectomy

Laparoscopic vs. Conventional Cholecystectomy

Laparoscopic Removal

 

 

Devices designed for Laparoscopic Surgery:

 

 

See also:

 

 

References:


[1] Luntzer, R., Urbanek, B., Saldjiyska, A., Berger, I., & Klimscha, W. (2009). An Evaluation of continuous non-invasive arterial pressure monitor ( CNAPTM Monitor ) in urological surgery Conclusion: Poster, 2–2.

 

[2] Lopes, M., et al., Goal-directed fluid management based on pulse pressure variation monitoring during high-risk surgery: a pilot randomized controlled trial. Critical Care. doi:10.1186/cc6117 (2007).

 

[3] Michard, F., et al. Rational fluid management: dissecting facts from fiction. BJA. 108(3):369-71 (2012).

 

[4] Biais, M. et al., The ability of pulse pressure variations obtained with CNAP™ device to predict fluid responsiveness in the operating room; Anesthesia and analgesia, 523-28 (2011).

 

[5] Wagner, J. Y., Grond, J., Fortin, J., Negulescu, I., Schöfthaler, M., & Saugel, B. (2015). Continuous noninvasive cardiac output determination using the CNAP system: evaluationof a cardiacoutputalgorithmfortheanalysisofvolumeclampmethod-derived pulse contour. Journal of Clinical Monitoring and Computing. doi:10.1007/s10877-015-9744-1