The effect of active gas aspiration to reduce pain after laparoscopic sleeve gastrectomy for morbid obesity: a randomized controlled study

Abstract

IntroductionResidual, intra-abdominal CO<sub>2</sub> contributes to abdominal distension and pain after laparoscopic surgery. Our aim was to investigate the effects of active gas aspiration on postoperative outcomes and pain following laparoscopic sleeve gastrectomy.Material and methodsPatients were randomly assigned to either the active gas reduction group (Group 1, n = 69) or the control group (Group 2, n = 74). After completion of the operative procedures, residual gas was aspirated with a flexible cannula in Group 1. In Group 2, gas release from the abdomen was performed using the port site by opening the gas tap only. The demographic data, body mass index, educational status, operation time, insufflated CO<sub>2</sub> volume during the operation, and intraabdominal pressure were recorded. Postoperative pain assessment was performed using a numerical pain intensity scale (NPIS) at the 1st h, the 24th h, and the 3rd day.ResultsNPIS scores at the 24th h were significantly lower in Group 1 (p < 0.001). However, there were no significant differences in the NPIS scores following the 1st h and the 3rd day. No differences were found in the operation time (p > 0.05). According to the correlation analysis between the operation time and NPIS scores between the groups, in Group 1 the duration of surgery was significantly proportional to NPIS24. All patients were discharged from the hospital on the 4th postoperative day.ConclusionsActive aspiration of the remaining gas just before the removal of the trocars is a simple procedure that reduces pain, leading to a more comfortable hospital stay.