@entity1 undergoing gynecological surgery under laparoscopic guidance usually receive general anesthesia with endotracheal intubation and mechanical ventilation. The creation of a @entity516 and the Trendelenburg position, both of which are used to improve visualization, are associated with cephalad movement of the diaphragm. This may increase the risk of endobronchial intubation. We studied the change in the distance from the tip of the endotracheal tube (ETT) to the carina with a fiberoptic bronchoscope in 30 @entity1 aged 21-40 yr who were undergoing laparoscopic tubal ligation (n = 28) or hysterectomy (n = 2). Measurements were taken in the supine and Trendelenburg positions before and after @entity516 . The average distance from the ETT to the carina in the supine position was 2.1 +/- 0.8 cm and in the Trendelenburg position was 1.8 +/- 0.8 cm (P = not significant). After insufflation of the abdominal cavity, the mean distance decreased to 0.7 +/- 1.4 cm in the supine position (P < 0.05) and was associated with endobronchial intubation in eight @entity1 . The addition of the Trendelenburg position to an @entity516 resulted in minimal displacement (0.54 +/- 1.4 cm, P < 0.05) and one additional endobronchial intubation. We conclude that the insufflation of gas in the abdominal cavity, and not the change in @entity1 position, is the main risk factor for endobronchial intubation in @entity1 undergoing laparoscopic gynecologic surgery. IMPLICATIONS: This study demonstrated that in anesthetized @entity1 , the insufflation of gas into the abdomen during laparoscopy for gynecologic surgery is the main risk factor for migration of the endotracheal tube into a bronchus.

XXXX as a risk factor for endobronchial intubation during laparoscopic gynecologic surgery.

@entity1 :: ('9606', 'Species') :: ['women', 'Patients', 'patients', 'patient'] @entity516 :: ('MESH:D011027', 'Disease') :: ['pneumoperitoneum', 'established pneumoperitoneum']
@entity516 :: (MESH:D011027,Disease) :: ['Pneumoperitoneum']
