Issn Print: 0265-0215

Publication Date: 2010/06/12


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Impact of laparoscopy on the abdominal compliance is determined by the duration of the pneumoperitoneum, the number of gravidity and the existence of a previous laparoscopy or laparotomy: 1AP9–3

K. Verbeke; I. Casier; B. VanAcker; B. Dillemans; J. Mulier

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Background and Goal of Study: We found in a previous study that in some patients the pneumoperitoneum volume increased at the end of the surgery. We found also that patients who had multiple pregnancies, laparoscopies or laparatomies had a larger abdominal compliance at the start of the pneumoperitoneum. Our hypothesis is that a pneumoperitoneum changes the abdominal compliance more in long procedures and in patients who have never been pregnant, never had a laparoscopy or laparotomy.
Materials and Methods: Female patients scheduled for a laparoscopic procedure and who did give informed consent were included in this study. The number gravidity, previous laparotomies, laparoscopies and the length of the pneumoperitoneum was recorded. The abdominal pressure volume relation was measured with three data points (1) at the start and at the end of the pneumoperitoneum allowing the calculation of the inflated volume at 15 mmHg. A multivariate analysis on the effect of time, gravidity, previous laparoscopy, laparotomy for the change in laparoscopic volume at 15 mmHg was performed.
Results and Discussion: 64 female patients were included in this study having primarily gynecologic or bariatric surgery procedures. The abdominal compliance did change less if the patient had a previous laparotomy, laparoscopy, multiple gravidities or a very short pneumoperitoneum. The inflated abdominal volume rose in all the other patients indicating a rise in abdominal compliance during pneumoperitoneum. As the intra abdominal pressure was set almost identical in most patients no conclusions could be made on the impact of this factor. These results might indicate that previous abdominal wall overstretching is permanent. This group of patients had indeed a larger abdominal compliance at the start of a laparoscopy as previously described (2) with a smaller increase in abdominal compliance at the end.
Conclusion(s): The abdominal compliance increased after laparoscopy but less if the patient had a previous laparotomy, laparoscopy, multiple gravidities or a short duration of pneumoperitoneum.

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