Comparing Clinical Impacts Between Valveless Trocar System and Standard Insufflation in Bariatric Surgery

Abstract

Purpose In laparoscopic surgery, higher intra-abdominal pressure is needed to achieve a well-exposed surgical field in obese patients, which may results in undesirable effects on cardiopulmonary systems. The AirSeal Intelligent Flow System™ provides stable pneumoperitoneum and constant smoke evacuation. However, studies regarding VTS in bariatric surgery are rare. This study aimed to investigate the effects of VTS on laparoscopic bariatric surgery. Methods We conducted a retrospective study using our prospective database. Sixty patients were enrolled equally to the VTS group and standard insufflation device group. Patient characteristics, intraoperative and postoperative data were analyzed. The Visual Analog Scale (scores: 0–10) was applied to measure the intensity of shoulder pain at 1, 12, 24, and 48 h after surgery, and surgeon’s satisfaction on the surgical field visualization was assessed using a numerical rating scale of 0 (not adequate) to 10 (optimal). Results There was no significant difference in bradycardia during insufflation, operative time, blood loss, shoulder pain, and complications as well as shoulder pain between groups. VTS group showed a significant higher scores of surgical field visualization. Conclusions There was no significant difference in most perioperative and postoperative outcomes; however, VTS group achieved a better surgical field visualization for surgeons.