Arthrex Synergy Insufflation FM134 Instructions D'utilisation page 32

Device Use and Control with Bariatric Operating Mode
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patients with normal body weight.
WARNING!
Heart and cardiovascular insufficiency
Constantly monitor all heart and cardiovascular parameter during surgery since
morbidly obese patients have an increased risk of heart and cardiovascular insuf-
ficiencies.
WARNING!
Metabolic and cardiac reactions
Insufflating CO may result in metabolic acidosis. This can lead to cardiac irregu-
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larities expressed with the following symptoms:
• Reduced respiration with restricted diaphram function
• Hypercapnia
• Reduction of venous reflux
• Reduced cardiac output
• Metabolic acidosis
WARNING!
Hypothermia/monitoring body temperature
The gas flow can lead to a lowering of the patient's body temperature during in-
sufflation. Hypothermia during insufflation can cause heart and cardiovascular
problems. The risk for hypothermia can be significantly reduced with the use of
gas that is pre-warmed to body temperature. Always monitor the patient's body
temperature during the entire insufflation. Make especially sure that the follow-
ing, hypothermia promoting, surgical conditions are avoided as best as possible:
• High gas flow due to large leaks
• Long surgeries
• Use of cold (not preheated) irrigation and infusion solutions
WARNING!
Dehydration
Insufflation can lead to dehydration of the tissue. This can result in organ tissue
damage and cardiovascular reactions of the patient. Long surgeries and large
leaks increase the risk of dehydration (especially at the insertion points of the
trocars or when changing instruments).
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
risk, use a low flow rate for the first insufflation and ensure that the insufflation
instrument is correctly positioned. Check the position of the insufflation instru-
ment immediately if the actual pressure rapidly reaches the nominal pressure
value. CO embolisms can also be caused by a high intra-abdominal pressure.
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Avoid high-pressure 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 insuffla-
embolisms. To reduce the
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