Argon Gas as the Distending Medium in Laparoscopic Surgery: A Preliminary Report

ABSTRACT

The objective of this study was to determine whether the inert gas argon may be used as a distending medium during laparoscopic tubal sterilization under local anesthesia and IV analgesia/sedation. Twenty-five patients scheduled for laparoscopic tubal sterilization under local anesthesia were given argon as a distending gas. Lidocaine was used as the local anesthetic. Operative pain was measured based on intraoperative analgesia requirements, and a modified McGill pain questionnaire was used to assess pain at 15 mins, 1 h, and 24 h postoperatively. Insufflation with argon gas caused no discomfort during surgery and minimal or no discomfort postoperatively, thus requiring minimal analgesia. Because of its similar density to carbon dioxide (CO₂) and nitrous oxide (N₂O) (atomic weight 40 compared with molecular weight of 44 for CO₂ and N₂O), this gas was used interchangeably in the standard laparoscopic insufflation machine. In this preliminary study, the inert gas argon was shown to be well tolerated by the patient. Because of the hazards of N₂O (supports combustion, pollutant in the operating room) and CO₂ (carbonic acid formation with peritoneal irritation and absorption with elevation of blood pH and PCO₂), argon gas may prove to be a preferred alternative in selected cases for abdominal distention in laparoscopy. Although studies with helium have been conducted with laparoscopic cholecystectomy under general anesthesia, showing a reduced PCO₂ and acidosis compared with CO₂, to our knowledge this is the first report of argon gas being used for distention in laparoscopy. (J GYNECOL SURG 11:233, 1995)