A Comparative Study of Low Versus Standard Intraperitoneal Pressures in Gynaecological Laparoscopic Surgery
Anup R. Patil
Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Science (Deemed to be university), Wardha, Maharashtra, India.
Deepika Dewani *
Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Science (Deemed to be university), Wardha, Maharashtra, India.
Kalyani Mahajan
Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Science (Deemed to be university), Wardha, Maharashtra, India.
Neema Acharya
Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Science (Deemed to be university), Wardha, Maharashtra, India.
Arpita Jaiswal
Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Science (Deemed to be university), Wardha, Maharashtra, India.
Saunitra A. Inamdar
Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Science (Deemed to be university), Wardha, Maharashtra, India.
Sparsh Madaan
Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Science (Deemed to be university), Wardha, Maharashtra, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Minimal access surgery in contrast to open surgery has quicker recovery during the postoperative period as well as reduced scores of pain. As a result of increased pressure in the abdominal cavity, laparoscopic surgery has many implications over a range of organ systems as well as their functioning. Laparoscopic surgery due to increased intraabdominal pressure also has many implications on various organ systems and their functioning. To overcome the consequences of increased intrabdominal pressure, a number of trials have been formulated to compare low- versus standard-pressure pneumoperitoneum.
Aim: The aim of this study was to assess the effectivity of low intraperitoneal pressures v/s standard intraperitoneal pressure during laparoscopic hysterectomies.
Study Design: Experimental study
Materials and Methods: 40 cases with uncomplicated symptomatic benign uterine pathologies who were posted for laparoscopic hysterectomy were selected out of which 20-20 cases were randomized into low and standard pneumoperitoneum groups.
Results: In patients in whom low pressure pneumoperitoneum is employed are better recovered in terms of pain than standard pressure pneumoperitoneum. This means hospital stay can be shortened in low pressure pneumoperitoneum groups which will be more economical and comfortable for patients.
Conclusion: Laparoscopic hysterectomy can be done at 10 mmhg with the benefits of :
- Optimum visualization with low pressure
- Reduction in post operative pain helping the patient for early ambulation so that patient will get back to routine work and normal life earlier, it is the main purpose of minimal invasive surgery.
Keywords: Laparoscopy, pneumoperitoneum, hysterectomy