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Comparative study of low pressure versus standard pressure pneumoperitoneum in laparoscopic cholecystectomy--a
Deepaesh Benjamin Kanwer1, Lileswar Kaman, M Nedounsejiane
1Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh-160012, India.
Introduction:
Standard pressure pneumoperitoneum for laparoscopic cholecystectomy employs a pressure range of 12-14 mm Hg. An emerging trend has been the use of low pressure pneumoperitoneum in the range of 7-10 mm Hg in an attempt to lower the impact of pneumoperitoneum on the human physiology while providing adequate working space. Our study proposes to compare the use of low pressure pneumoperitoneum with the use of standard pressure pneumoperitoneum.
Methods:
A randomised controlled trial consisting of 60 patients with symptomatic gallstone disease who underwent laparoscopic cholecystectomy, of which 30 patients were subjected to standard pressure pneumoperitoneum during the procedure and 30 patients to low pressure pneumoperitoneum.
Results:
Both groups were comparable in all aspects. The mean operating time with low pressure pneumoperitoneum was 49.07 +/- 5.72 minutes and with standard pressure pneumoperitoneum was 46.43 +/- 6.92 minutes. There was no statistically significant change in blood pressure, heart rate, pain at 6 hours, need for additional analgesia or shoulder tip pain with the use of lower pressure pneumoperitoneum.
Conclusions:
Low pressure pneumoperitoneum benefits the patient in the form of lower intensity of postoperative pain but it does not positively impact intraoperative hemodynamics.