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Hemocoagulative Modifications after Laparoscopic Surgery at Different Pneumoperitoneum Pressure Settings.

Intagliata Eva¹, Vecchio Rosario¹, Saitta Cesare²

¹Department of General Surgery and Medical Surgical Specialties, University of Catania, Policlinico "G. Rodolico - San Marco", Via S. Sofia 78, 95123 Catania, Italy.

International Journal of Surgery Protocols

|July 8, 2022

Summary

Laparoscopic surgery may alter blood clotting, with higher intra-abdominal pressure potentially increasing prothrombotic states. Further research is needed to optimize pneumoperitoneum settings for patient safety.

Keywords:

hemocoagulation laparoscopy pneumoperitoneum pneumoperitoneum pressure

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Area of Science:

Surgical Oncology
Anesthesiology
Hematology

Background:

Laparoscopic surgery's effects on cardiovascular, respiratory, and metabolic systems are known, but hemocoagulative parameter changes remain understudied.
This study investigates hemocoagulative variations in patients undergoing elective laparoscopic cholecystectomy for symptomatic gallbladder stones.
The goal is to identify if specific pneumoperitoneum pressure settings influence these changes, potentially reducing complications.

Discussion:

Pneumoperitoneum, particularly at higher pressures (12 mmHg), was associated with increased D-dimer levels and alterations in Factor II, von Willebrand factor, and Protein C.
Lower pneumoperitoneum pressure (8 mmHg) showed significant decreases in Antithrombin III and affected PT ratio and Protein C.
Despite intra-group variations, statistical analysis revealed no significant post-operative differences between the two pressure groups.

Key Insights:

Intra-abdominal pressure during laparoscopy influences hemocoagulative parameters.
Higher pneumoperitoneum pressure (12 mmHg) appears linked to a prothrombotic state.
Lower pneumoperitoneum pressure (8 mmHg) is associated with a statistically significant decrease in Antithrombin III.

Outlook:

Further studies are warranted to fully elucidate the relationship between pneumoperitoneum pressure and coagulation.
Optimizing intra-abdominal pressure could lead to safer laparoscopic procedures with fewer complications.
Understanding these hemocoagulative changes is crucial for improving patient outcomes in minimally invasive surgery.