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Flow-Controlled Ventilation in Laparoscopic Surgery: A Case Series
Ghali Ballout1, Marina Roger1, Raquel Bergé1
1From the Department of Anesthesiology, Hospital Clínic de Barcelona, Barcelona, Spain.
A&A Practice
|April 7, 2026
Summary
Flow-controlled ventilation (FCV) may improve breathing and gas exchange during complex surgeries. This method helped patients with obesity or in steep positions, suggesting it could reduce respiratory issues in high-risk surgical cases.
Area of Science:
- Anesthesiology
- Respiratory Physiology
- Surgical Innovation
Background:
- Laparoscopic surgery in obese patients and robotic procedures in steep Trendelenburg position can impair ventilation.
- These conditions increase the risk of postoperative pulmonary complications.
Purpose of the Study:
- To evaluate the ventilatory and gas exchange effects of Flow-Controlled Ventilation (FCV).
- To assess FCV's potential benefits in patients with significantly altered respiratory mechanics during surgery.
Main Methods:
- A case series involving four patients undergoing complex surgical procedures.
- Two patients had class III obesity undergoing bariatric surgery.
- Two patients underwent robotic urological procedures.
Main Results:
- FCV facilitated compliance-guided lung recruitment.
- Increased tidal volumes and improved PaO2/FiO2 ratios were observed.
- No respiratory complications occurred in any of the patients.
Conclusions:
- Flow-Controlled Ventilation may be beneficial in patients with altered respiratory mechanics during laparoscopic or robotic surgery.
- FCV demonstrated potential for improving lung function and gas exchange in challenging surgical scenarios.
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