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Routine low-pressure pneumoperitoneum during laparoscopic cholecystectomy.
D Davides1, K Birbas, A Vezakis
1Leeds Institute for Minimally Invasive Therapy, Centre for Digestive Diseases and The University Division of Surgery, The General Infirmary at Leeds, Great George Street, Leeds, LS1 3EX, UK.
Surgical Endoscopy
|August 18, 1999
Summary
Low-pressure insufflation during laparoscopic cholecystectomy (LC) is safe. This study found that performing LC at lower intra-abdominal pressure did not increase operative time or complications, suggesting improved patient safety and comfort.
Area of Science:
- Minimally Invasive Surgery
- Surgical Safety
- Anesthesiology
Background:
- Pneumoperitoneum at 15 mmHg can cause dangerous hemodynamic disturbances.
- Low-pressure insufflation may enhance the safety of laparoscopic surgery.
Purpose of the Study:
- To evaluate the safety and feasibility of performing laparoscopic cholecystectomy (LC) using low intra-abdominal pressure.
Main Methods:
- Prospective data collection from two groups of patients undergoing elective LC (1993-94 vs. 1996).
- Group 1 (n=77) had a mean intra-abdominal pressure of 10.56 mmHg; Group 2 (n=50) had a mean of 7 mmHg.
- Groups were comparable in demographics, ASA grade, surgical history, and gallbladder disease severity.
Main Results:
- Mean operative times were similar (75 min vs. 78 min).
- No significant differences in morbidity rates or postoperative hospital stay were observed.
- Additional cannula insertion was more frequent in the low-pressure group (24% vs. 14%), but not statistically significant.
Conclusions:
- Laparoscopic cholecystectomy can be routinely performed at low intra-abdominal pressure.
- Low-pressure pneumoperitoneum may contribute to improved safety and patient comfort during LC.