Routine low-pressure pneumoperitoneum during laparoscopic cholecystectomy

Background: Pneumoperitoneum at 15 mmHg results in dangerous hemodynamic di sturbances in some patients. The use of low-pressure insufflation may make laparoscopic surgery safer. Methods: Data were collected prospectively from a consecutive series of pat ients who had undergone an elective laparoscopic cholecystectomy (LC) by th e same surgeon, during the years 1993-94 (group 1, 77 patients) and 1996 (g roup 2, 50 patients). The groups were similar with respect to age, sex, bod y mass index (BMI), American Society of Anesthesiologists (ASA) grade, exis tence of abdominal scars due to previous surgery, and severity of gallbladd er disease. Patients underwent LC with a mean intraabdominal pressure of 10 .56 mmHg in group 1 and 7 mmHg in group 2, respectively. Results: The mean operative time was 75 min and 78 min in groups 1 and 2, r espectively (NS), Insertion of an additional cannula was required more freq uently (24% versus 14%; NS) in group 2. There were no conversions in either group. The morbidity rate and the postoperative hospital stay were similar for both groups. Conclusions: LC can be performed routinely at low intraabdominal pressure, which may contribute to the safety and comfort of the procedure.