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Hemodynamics during laparoscopy in the supine or prone position. An experimental study
J J Bannenberg1, B M Rademaker, P F Gründeman
1Department of Experimental Surgery, Academic Medical Center, University of Amsterdam, The Netherlands.
Surgical Endoscopy
|February 1, 1995
Summary
Laparoscopic surgery in the prone position does not worsen hemodynamic effects compared to the supine position. Increased intra-abdominal pressure during laparoscopy did not decrease cardiac output or oxygen transport in pigs.
Area of Science:
- Anesthesiology
- Surgical Innovation
- Physiology
Background:
- Laparoscopy is associated with arterial pressure changes and decreased cardiac output.
- Prone positioning in laparoscopy may offer surgical benefits.
- Hemodynamic effects of prone laparoscopy are not well understood.
Purpose of the Study:
- To investigate the hemodynamic effects of increased intra-abdominal pressure during laparoscopy in the prone position.
- To compare these effects with those in the supine position.
Main Methods:
- Eight pigs were studied in both prone and supine positions.
- Intra-abdominal pressure was incrementally increased to simulate pneumoperitoneum.
- Hemodynamics and oxygen transport were monitored.
Main Results:
- Elevated intra-abdominal pressure did not decrease cardiac output in either position.
- Oxygen transport and consumption remained stable despite increased intra-abdominal pressure.
- No significant difference in hemodynamic depression was observed between prone and supine positions.
Conclusions:
- Laparoscopy in the prone position does not induce more severe hemodynamic depression than in the supine position.
- Prone laparoscopy is a viable option with predictable hemodynamic effects.
- Further research may explore specific surgical applications.