Case 18: A Complication During Laparoscopy

Today you are scheduled to anesthetize a 28-year-old female for removal of the right fallopian tube ectopic pregnancy. She is otherwise healthy and you give her an ASA 1 classification. She weighs 72 kg and is 5 ft 10 in. tall. A routine general anesthesia is induced and maintenance is with 1–2% sevoflurane and 70% nitrous oxide in oxygen. The surgeon places a transurethral bladder catheter and attaches it to a soft plastic collection bag. Pneumoperitoneum is created with insufflation of 100% carbon dioxide to a pressure of 16 mmHg. Fifteen minutes into the case you notice that the urinary collection bag has become very distended.