Routine low-pressure pneumoperitoneum during laparoscopic cholecystectomy

Abstract

LC can be performed routinely at low intraabdominal pressure, which may contribute to the safety and comfort of the procedure.

Shoulder Tip Pain Following Laparoscopic Cholecystectomy—a Randomized Control Study to Determine the Cause

“…Some studies have also shown that the shoulder tip pain is minimal if the initial insufflation rate is kept suboptimal, although this needs to be substantiated. Some studies have shown that the incidence and intensity of postoperative shoulder tip pain was significantly less in the low-pressure pneumoperitoneum group when compared with standard-pressure pneumoperitoneum groups [8,[11][12][13][14][15][16]. Our study, however, shows that the incidence of shoulder pain has no statistical difference between groups undergoing laparoscopic surgery at different pneumoperitoneal pressures.…”

A prospective randomized trial on comparison of low-pressure (LP) and standard-pressure (SP) pneumoperitoneum for laparoscopic cholecystectomy

“…In order to minimize the adverse effects of pneumoperitoneum, the clinical practice was extended to include low-pressure pneumoperitoneum (5-7 mmHg) and the gasless technique based on abdominal integument lifting [some surgeons prefer supplementing the gasless technique with low-pressure pneumoperitoneum (4 mmHg) to achieve a better exposure of the There were no significant differences between the groups. Values are means ± SD; ASA, American Society of Anesthesiology surgical field] [3,15,19]. Although each of these techniques has its advantages and disadvantages, the rational approach seems to be to strive to employ minimum pneumoperitoneum pressure values that allow for a good exposure of the surgical field rather than to routinely employ only one technique in all patients, what has been reflected in the recommendations of EAES [12].…”

“…The maintenance of elevated intraabdominal pressure for the duration of the procedure is associated with numerous adverse effects involving the circulatory and respiratory systems, as well as the kidneys; some of these side effects result from a positive intraperitoneal pressure itself, while others are associated with carbon dioxide absorption from the peritoneal cavity to blood [3,7,8,11].…”

Feasibility and Safety of Low Pressure Pneumoperitoneum for Laparoscopic Cholecystectomy: A Prospective, Randomized, Triple-Blinded Trial

“…In other studies, more than 85% of LCs were completed in patients randomized to the low pressure group. No differences have been reported in the requirement for additional ports, conversion rate, operating time, or complication rates [10,11,17].…”