To the Editor:-The surgeon occasionally during laparoscopy requests insufflation of the stomach. This is usually done with a large syringe attached to the proximal end of a nasogastric tube. This technique has limitations because the pressure in the stomach is difficult to maintain at a certain pressure for a period of time.
We use the emergency jet ventilator attached to our anesthetic machine and find it efficient and safe. A 14-gauge catheter is attached to the distal end of the jet ventilator. The catheter is then placed in the proximal large lumen of the nasogastric tube. The stomach is gently distended by pressing on the lever of the jet ventilator. We observe the stomach being distended on the TV monitor. To get a feel for the pressures that the jet ventilator can produce (50 psi), it is recommended that one attempt to distend a surgical glove initially before using it to distend the stomach. Although there is a theoretical potential for overdistension of the stomach, we have used this technique in the past 3 yr on approximately 30 patients without a problem.
We hope your readership may find this useful.
John G. Brock-Utne, M.D., Ph.D.
Mark Vierra, M.D.
Departments of Anesthesia and Surgery; Stanford University Medical Center; Stanford, California 94305
(Accepted for publication July 25, 1997.)