Pneumoperitoneum in the cancer patient: advantages and pitfalls

The use of pneumoperitoneum to create a working environment for laparoscopic surgery may have both beneficial and detrimental effects in cancer patients. Studies suggest that immune mechanisms are protected when laparoscopic procedures are used and this does not seem to be compromised by the use of gas in the abdomen. Potential pitfalls in the utilization of pneumoperitoneum include the effects of hypothermia, cardiovascular consequences, hypercoagulability with associated deep-venous thrombosis, and the possibility that trocar-site recurrences may be produced by using a pneumoperitoneum. No concrete evidence of either beneficial or detrimental effects from pneumoperitoneum in cancer patients currently exists. Studies utilizing animal models and humans should be supported in this extremely important area.