Minimally invasive oesophagectomy is a relatively new procedure that is performed by means of thoracoscopy and laparoscopy. One stage of the procedure involves creation of a peritoneo-pleural communication in the presence of a pneumoperitoneum. In the case presented, severe hypotension occurred at this point. We believe this was caused by the escape of carbon dioxide from the peritoneal cavity into the right hemithorax, resulting in tension pneumothorax and cardiac tamponade. We believe this to be a predictable complication of this procedure but one that if expected, recognised and correctly managed, should not result in adverse outcomes.
GerhartC.D.Hand-assisted laparoscopic oesophagectomy using the dexterity pneumo sleeve.J Soc Laparoendosc Surg1998; 2: 295–298.
2.
WatsonD.I., DaviesN., JamiesonG.G.Totally endoscopic Ivor Lewis oesophagectomy.Surg Endosc1999; 13: 293–297.
3.
SwanstromL.L., HansenP.Laparoscopic total oesophagectomy.Arch Surg1997; 132: 943–947.
4.
ChuiP.T., MainlandP., ChungS.C., ChungD.C.Anaesthesia for three-stage thoracoscopic ooesophagectomy: an initial experience.Anaesth Intensive Care1994; 22: 593–596.
5.
NguyenN.T., SchauerP.R., LuketichJ.D.Combined laparoscopic and thoracoscopic approach to oesophagectomy.J Am Coll Surg1999; 188: 328–332.
6.
NguyenN.T., FolletteD.M., WolfeB.M., SchneiderP.D., RobertsP.Goodnight JE Jr. Comparison of minimally invasive oesophagectomy with transthoracic and transhiatal oesophagectomy.Arch Surg2000; 135: 920–925.
7.
PedenC.J., Prys-RobertsC.Capnothorax: implications for the anaesthetist.Anaesthesia1993; 48: 664–666.
8.
EverettL.L., SpottswoodS.E.Intraoperative desaturation and unilateral breath sounds during Nissen fundoplication.Anesth Analg2000; 90: 62.
