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Influence of pneumoperitoneum pressure on surgical field during robotic and laparoscopic surgery: a comparative study.

Abstract：

PURPOSE:Studies on the influence of CO₂ pneumoperitoneum on the abdominal cavity during robotic procedures are lacking. This is the first study to evaluate surgical field modifications related to CO₂ pressure, during laparoscopic and robotic surgery. METHODS:Consecutive patients scheduled for laparoscopic or robotic hysterectomy were enrolled in the study. To evaluate the level of operative field visualization, a dedicated form has been designed based on the evaluation of four different areas: Douglas space, vesico-uterine fold and, bilaterally, the broad ligament. During the initial inspection, an assistant randomly set the CO₂ pressure at 15, 10 and 5 mmHg, and the surgeon, not aware of the CO₂ values, was asked to give an evaluation of the four areas for each set pressure. RESULTS:In laparoscopic group, CO₂ pressure significantly influenced the surgical field visualization in all four areas analyzed. The surgeon had a good visualization only at 15 mmHg CO₂ pressure; visualization decreased with a statistically significant difference from 15 to 5, 15-10 and 10-5 mmHg. In robotic group, influence of CO₂ pressure on surgical areas visualization was not straightforward; operative field visualization remained stable at any pressure value with no significant difference. CONCLUSIONS:Pneumoperitoneum pressure significantly affects the visualization of the abdomino-pelvic cavity in laparoscopic procedures. Otherwise, CO₂ pressure does not affect the visualization of surgical field during robotic surgery. These findings are particularly significant especially at low CO₂ pressure with potential implications on peritoneal environment and the subsequent post-operative patient recovery.

journal_name

Arch Gynecol Obstet

journal_title

Archives of gynecology and obstetrics

authors

Angioli R,Terranova C,Plotti F,Cafà EV,Gennari P,Ricciardi R,Aloisi A,Miranda A,Montera R,De Cicco Nardone C

doi

10.1007/s00404-014-3494-z

subject

Has Abstract

pub_date

2015-04-01 00:00:00

pages

865-8

issue

eissn

0932-0067

issn

1432-0711

journal_volume

291

pub_type

杂志文章

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Influence of pneumoperitoneum pressure on surgical field during robotic and laparoscopic surgery: a comparative study.