Pneumoperitoneum risk prognosis and correction of venous circulation disturbances in laparoscopic surgery

Abstract

The PPP model is quite similar to the real PP and can be used for preoperative prognosis in laparoscopic surgery. The elevated intraabdominal pressure results in a significant disturbance of venous blood flow in the lower extremities. The use of the device for peristaltic pneumomassage of the lower limbs is effective in correcting negative changes in venous hemodynamics in laparoscopic surgery.

Is laparoscopic surgery safe in women over 70 years old with benign gynecological disease?

“…Such factors may cause surgeons to hesitate in deciding on the method of laparoscopic surgery used for elderly women. However, the increased intra‐abdominal pressure arising from the pneumoperitoneum is reported to show a fast recovery with postoperative CO 2 gas elimination, and the risk of reduced venous circulation can be minimized in the elderly by maintaining a low intra‐abdominal pressure during surgery 14,15 …”

The European Association for Endoscopic Surgery clinical practice guideline on the pneumoperitoneum for laparoscopic surgery

“…Various laparoscopic procedures have been shown to result in better postoperative pulmonary function when compared to their open-surgery counterparts (1b [38,42,48,51,74,112,149,167,197,206,275,307]), but clinically more relevant end points such as postoperative pulmonary complications were rarely evaluated or found unchanged in ASA I and II patients (1b [205,206]). These data generally prove that laparoscopy rather than conventional surgery should be advised for compromised patients, particularly those with obstructive lung disease.…”

“…Hypoventilation and hypercarbia increase ICP compared to hyperventilation and hypocarbia, but during acute elevations of ICP hyperventilation did not decrease ICP eectively (5 [251]). The insuation gas has fewer eects on ICP than on IAP (4 [74], 5 [60]). …”

The effect of different levels of peritoneal CO 2 pressure on bleeding time of spleen capsule injury

“…There are some studies showing that the increased intraabdominal pressure causes venous stagnation in the lower extremities, thus increasing the risk of thrombosis. Data of other experimental studies show that during laparoscopy the CO 2 pneumoperitoneum has no direct physical or biochemical influence on coagulation tests [5,9]. The aim of these studies was to identify the safety pressure range, which is the best for both the patient and the surgeon.…”