Takuya Shiraishi

Carbon dioxide embolism during transanal total mesorectal excision (taTME)

Transanal total mesorectal excision (taTME) is a relatively new surgical approach that has become increasingly common for patients with low rectal cancer. This approach uses subperitoneal carbon dioxide (CO2) to create the pelvic workspace and perform the operation from the anal side. Thereby, a good surgical performance is achieved for a narrow pelvis, which is difficult with laparoscopy from the abdominal side. However, taTME is associated with potentially life-threatening complications, including CO2 embolism [1], which is not a commonly encountered complication during laparoscopic TME. This complication may be important in a transanal approach, and surgeons performing taTME need to be aware of this potential event to prevent major morbidity. Here, we report our experience with 2 patients who had a sudden drop in end-tidal carbon dioxide (ETCO2) that was suspected to be due to CO2 embolism during taTME.

Influence of mixture preparation on HC emission of SI engine with high swirl ratio under cold conditions

Abstract This study investigates the effects of injection timing and fuel atomization on engine-out HC emission of an Sl engine with a high swirl ratio under cold conditions. To study the air-fuel mixture formation process inside the intake port and cylinder, laser visualization techniques were applied and their results were compared with the measured HC emission. Although the performance test indicated that the HC emission deteriorated in the case of one-intake-port operation, the HC emission was recovered by fuel atomization by an air-assisted injector and backflow from the cylinder into the intake port at the beginning of the intake stroke.