Gas conditioning

Abstract

A compound for the manufacturing of a medicament for reducing or preventing mesothelial cell damage includes a mixture of a carrier gas and between 1 volume percent and 29 volume percent of nitrous oxide gas (N2O) and can be used for prevention of adhesion formation, pain reduction, reducing or preventing acute inflammation, reducing or preventing CO2 resorbtion or reducing tumor cell implantation upon surgery.

Description

FIELD OF THE INVENTION[0001]The present invention relates to products and systems for operation trauma prevention or reduction. More particularly, the present invention relates to compounds, e.g. for use as a pneumoperitoneum and / or gas for flowing over a body part during surgery, to systems controlling the use thereof and to methods of using such compounds or systems.BACKGROUND OF THE INVENTION[0002]In order to perform a laparoscopy the abdomen, which is a virtual cavity, has to be insufflated in order to create a working space. Insufflation pressure is limited to 15 mm of Hg out of fear of gas embolism , although this limit has not been substantiated clinically. CO2 has been traditionally used as a gas for the pneumoperitoneum out of safety concerns. Indeed CO2 has a high solubility in water and an high exchange capacity in the lungs. Therefore the risk of a gas embolism causing a hearth tamponnade should be minimal.[0003]During laparoscopic surgery some flow through the abdominal...

AI Technical Summary

Benefits of technology

"The present invention provides a method and system for using a mixture of nitrous oxide gas and a carrier gas for reducing or preventing damage to the peritoneal cavity during surgery. This gas mixture can be used as a medicament to reduce or prevent adhesion formation, pain, inflammation, and CO2 resorption. The gas mixture can be supplied to the cavity where surgery is performed using a gas supplying means, such as an endoscopic insufflation means or a gas location means. The gas mixture can also be conditioned using a sprinkler or a controller for controlling the temperature and humidity of the cavity. Overall, the invention provides an efficient and effective way to assist in surgery and reduce the risk of complications."

Problems solved by technology

Especially the high flows used together with a CO2 laser, can induce important uncontrolled desiccation and temperature alterations in the abdominal cavity.

During open surgery, the abdominal content is directly exposed to the air with important desiccation and exposure of the superficial cells to 20% of oxygen, proven to be toxic for the mesothelial cell layer.

It is to be noticed that surgical interventions in the human occasionally may be very long interventions.

Adhesions following surgery are clinically important and cause suffering to the patients and a burden for the cost of health care.

Repeat surgery moreover is more difficult, more tedious and associated with more complications because of adhesions.

From these findings, models have been constructed indicating an enormous cost of adhesions formation for society besides the cost of suffering of the individuals.

Besides good surgical practice, adhesion prevention in the human has been limited to barriers and flotation agents with a reduction of adhesion formation that ranges for all products between 40% to 50%.

This can be explained by the high intra-individual variability, and the variability in surgical interventions which make adequate randomized clinical trials prohibitively large.

Sheet barriers such as Seprafilm (Hyaluronic acid-carboxymethylcellulose), Interceed (Oxidized regenerated cellulose) and Gore-tex(Expanded polytetrafluoroethylene) are proven effective but did not become very popular for various reasons.

A comparison between these 3 gels can unfortunately not be made since comparative trials do not exist.

The strength of the available evidence demonstrating efficacy, is in a Cochrane review not considered very solid.

In this model, dexamethasone further decreased adhesions, whereas anti-inflammatory agents (NSAID's, COX1, COX2 inhibitors) and anti-TNFa monoclonals were close to ineffective.

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