Shoulder Pain is a Common Problem Following Laparoscopic Adjustable Gastric Band Surgery

Australian Centre for Obesity Research and Education, Monash Medical School, The Alfred Hospital, Melbourne, Australia.
Obesity Surgery (Impact Factor: 3.75). 10/2005; 15(8):1111-7. DOI: 10.1381/0960892055002149
Source: PubMed


Shoulder-tip pain is commonly reported following laparoscopic adjustable gastric band (LAGB) placement. The incidence, nature and factors that may increase the risk of pain have not been explored.
A prospective extensive collection of patient characteristics and operative details was obtained from consecutive patients having band placement for severe obesity. Postoperatively, the presence and characteristics of shoulder pain were obtained using a structured interview at discharge from hospital, and at 1 and 5 weeks after placement.
66% and 21% of patients at 1 and 5 weeks respectively following surgery reported pain predominantly in the left shoulder. At 5 weeks, only 7% found the pain of concern and 5% required analgesics. There were no factors found that predicted the presence and severity of pain at 1 week. Injury to the crus of the diaphragm (OR 4.2, 1.4-12.6, P=0.01) and a past history of any upper abdominal surgery (OR 4.2, 1.5-11.7, P=0.007) independently predicted an increased risk of pain at 5 weeks.
Shoulder pain following LAGB surgery is common, usually affects the left shoulder, and can in some cases last 5 weeks or more. Avoiding injury to the crura during the procedure may prevent more prolonged pain.

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    • "The INSI is also used to reduce laparoscopy-induced pain. It works by increasing intraperitoneal pressure, similar to PRM while also offering a physiologic buffer system to dissolve excess carbon dioxide Warm isotonic saline is left at the abdominal cavity (about 25-30 mL/Kg of body weight)[14]. Carbon dioxide dissolves in water and forms carbonic acid, which is absorbed into the intravascular space, it contacts with red blood cells, where carbonic anhydrase transforms carbonic acid into bicarbonate, which is finally expelled at the lung as carbon dioxide. "
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