Authors Keywords: Surgical emphysema, hypercarbia, laparoscopic surgery, extraperitoneal, laparoscopic total extraperitoneal (TEP) Abstract

This case report describes a 69-year-old male patient who underwent laparoscopic inguinal hernia repair using a total extraperitoneal approach. Complications during the procedure were hypercarbia, surgical emphysema, and pneumothorax. Immediate interventions were necessary to address the rising end-tidal CO2 levels, hypercarbia, and acidosis. The incidence of these complications may be higher than previously reported, particularly in extraperitoneal laparoscopic procedures, underscoring the importance of increased awareness among anaesthesiologists. This case report emphasises the significance of monitoring CO2 inflation pressure, assessing subcutaneous CO2 accumulation, and adjusting ventilation to enhance patient safety and promote the reporting of such complications in the future.

Author Biography F Uys, University of Cape Town

Registrar, Division of Anaesthesiology and Perioperative Medicine, Groote Schuur Hospital, University of Cape Town, South Africa

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Case Studies

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