Submitted by cimmic t3_11aj45n in askscience
Comments
analcaynal t1_j9u37po wrote
Just had my tubes tied via laparoscopic surgery. The gas makes your shoulders hurt.
619364290163 t1_j9u5gm0 wrote
That is due to irritation of the diaphragm caused by the CO2 and expansion of the intra-abdominal cavity. Should decrease in a few days time!
theluckyfrog t1_j9wnslx wrote
After my first laparoscopic abdominal surgery, the only pain was from the single longer incision that they pulled stuff out of. After my second laparoscopic abdominal surgery, the only pain was the CO2 shoulder pain. After my third laparoscopic abdominal surgery, there was no pain at all. Weird how even the same body can have such different repeat results.
619364290163 t1_j9xyzd1 wrote
(Was asleep therefor a bit late of a response) That can also be due to the pressure used to inflate the abdomen. different levels of pressure are used to inflate the abdomen depending on where to operate and what to do (I.e. more pressure thus more expansion (and possible pain) can be required if you have to manoeuvre around a big cyst and less can be used to clip someone’s tubes. But it also depends ik how the internal organs and peritoneum (inner lining of the abdomen) are manipulated
theluckyfrog t1_j9yes1a wrote
Well, in order I had a small bowel resection, a total colectomy w/ ostomy, and a relocation of said ostomy w/ a proctectomy and a separate small bowel resection. Thankfully, I did not need the big abdominal incision I was afraid of having for the procectomy--they did everything through the anal incision. I know they did some local anaesthesia to the abdomen with that last surgery but I was still shocked that neither it nor my previous ostomy hurt ANY. I assume all the credit goes to the continued advancement of surgery techniques--each of my surgeries was 8-10 years apart.
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bdhubbard t1_j9w1l6y wrote
Common complaint from my laparoscopic patients. C02 gets trapped above the liver and irritates the diaphragm which shares some nerves with the shoulder/arm. More common on the right because the liver is there to trap some of the excess gas. The pain usually goes away in 24-48 hours.
Lynxieee t1_j9xry1z wrote
that's super interesting. I punctured a lung once and when I came to I was 100% sure something had broke in my shoulder as the pain was super intense from all the air suddenly outside of the lung. Meanwhile my sternum was actually broken and didn't hurt anywhere near as much.
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CATHYINCANADA t1_j9x3aof wrote
That was expected by me. Like muscle pain that you can't do anything about.
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EclecticFruit t1_j9tp3r6 wrote
Now I want to hear you speak u/djublonskopf name out loud to give credit. 🤣
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UnkindPotato t1_j9v6if7 wrote
So if you got surgery and then got on an airplane too soon would you explode or would you just fart out the stitched up hole
metalmaxilla t1_j9vv59l wrote
In certain eye surgeries, gas is used to fill the eye and one can't fly for 6 weeks afterwards depending on the gas used. The gas can expand, causing increased intraocular pressure, which can be painful and result in blindness.
djublonskopf t1_j9w2x9f wrote
This is true. In the 6-week case, the eye has probably been intentionally filled with octafluoropropane (C3F8) to keep the gas from being reabsorbed too quickly…this gives the retina more time to remain dry to allow more healing before the gas is absorbed and replaced by fluid.
If the eye is filled with normal air, the air should be reabsorbed in a much shorter time (2-10 days).
metalmaxilla t1_ja3wu3h wrote
Thank you for the verification. However, this is not technically for the retina to remain 'dry'. This technique effectively 'holds pressure' to keep tissues in place against each other to facilitate them attaching and healing together. It can initially involve head positioning to strategically move the gas bubble against the desired tissue of interest. Gas bubbles can also be used in partial (descemet membrane) corneal transplants.
Mixtures of air +/- SF6 or C3F8 can be used. Air does reabsorb more quickly and is less expansile than the others. The emphasis of my comment was that one cannot fly while gas is in the eye. This is called "gas precautions", and patients may receive a medical alert bracelet during this period.
The eye can also be filled with liquid in lieu of gas, such as silicone oil, which is flying-friendly but requires another surgery to remove it if it's not left in place permanently.
NobodysFavorite t1_j9ww85t wrote
What's more, unrelated to surgery... if you go scuba diving you can't safely expect to fly on the same day afterwards. You need to allow 24hrs for the dissolved gas levels in your body to get back to a "safe to fly" level.
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Uncynical_Diogenes t1_j9vmye2 wrote
The difference in air pressure between a pressurized cabin and sea level is not really enough to make that much of a difference.
Now, if you teleported right into outer space, you could expect that gas to find the path of least resistance out of you, probably the incision, but you’re not going to “blow up”.
Joygernaut t1_j9vw0ju wrote
Thank you! I am a short stay surgical nurse, and I have often explained to patients that the air that is blown up and their abdominal cavity will be absorbed by their body, but I did not know that they used to CO2 and this information will significantly help when I inform people have their body will process the gas that is used to blow up the abdominal cavity during laparoscopic surgery. Thankyou!!!
NobodysFavorite t1_j9wwj14 wrote
Also oxygen at the wrong partial pressures is toxic.
The body is very good at detecting and removing CO2 so we take advantage of that.
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CastorTJ t1_j9wo5m5 wrote
CO2 is largely used also because O2 would be a fire hazard in the body. CO2 naturally suppresses any chance of a surgical fire in the body.
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djublonskopf t1_j9tbhh0 wrote
It is absorbed by the body cavity lining, makes its way into the blood stream, and is exhaled. The absorption happens pretty much exactly the way it happens in your lungs (diffusion), there's just less surface area to work with than in the highly-branched lung interior, so it takes a bit longer.
O2 and CO2 are absorbed pretty quickly into the blood compared to the nitrogen gas (N2) that makes up the majority of air. So when laproscopic surgeons insuflate a surgical area with gas to give them a little more room to see and work, they intentionally use CO2...which helps any gas left behind after the surgery to be absorbed more quickly, and also protects the patient in case a (small) bubble got into the bloodstream (as a bubble of pure CO2 will be absorbed into the blood faster and thus might do less damage than a longer-lasting nitrogen bubble.) But even a regular air mix at an incision site will be absorbed before too long.