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Synthesis
When the tissues release carbon dioxide into the bloodstream, around 10% is dissolved into the plasma. The rest of the carbon dioxide is carried either directly or indirectly by Hemoglobin. Approximately 10% of the carbon dioxide carried by hemoglobin is in the form of Carbaminohemoglobin. This Carbaminohemoglobin is formed by the reaction between Carbon Dioxide and an amino (-NH2) residue from the Globin molecule, resulting in the formation of a Carbamino residue (-NH.COO-). The rest of the Carbon Dioxide is transported in the plasma as bicarbonate.

Hydrogen Ion and Oxygen-Carbon Dioxide Coupling
When carbon dioxide diffuses as a dissolved gas from the tissue capillaries, it binds to the α-amino terminus of the globulin chain, forming Carbaminohemoglobin. Carbaminohemoglobin is able to directly stabilise the T conformation as part of the carbon dioxide Bohr effect. Deoxyhemoglobin in turn subsequently increases the uptake of carbon dioxide in the form of favouring the formation of Bicarbonate as well as Carbaminohemoglobin through the Haldane effect.

Laparoscopy History
In 1987, Alfred Cuschieri performed the first minimally invasive surgery with his team at Ninewells Hospital after working with multiple researchers from across the world, including Patrick Steptoe. Cuschieri took advantage of smaller cameras to perform operations with smaller cuts and shorter recovery times. After some controversy and patient deaths, new laparoscopic training centres were set up as most surgeons lacked the necessary specialised training to perform laparoscopic surgery, with the first being opened in Dundee in 1991 - which later went on to become the Cuschieri Skills Centre that was opened in 2004 at Ninewells Hospital. As of 2008, there were 40 specialist centres around the world dedicated to laparoscopic training based and modified on the Cuschieri Skills Centre.