Journal
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
Volume 35, Issue 7, Pages 3670-3678Publisher
SPRINGER
DOI: 10.1007/s00464-020-07846-4
Keywords
Laparoscopic surgery; AirSeal (R); Pneumoperitoneum; Randomized; Cholecystectomy; Hernia
Categories
Funding
- Projekt DEAL, Eberhard Karls University Tubingen, Germany
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This study compared the surgical outcomes between patients undergoing the most frequently performed laparoscopic procedures using AirSeal(R) and standard CO2 insufflators. The results showed that the use of the AirSeal(R) system did not reduce operative time and was associated with higher postoperative shoulder tip pain compared to the standard CO2 insufflator for short elective surgeries.
Background AirSeal (R) is a valve-free insufflation system that enables a stable pneumoperitoneum with continuous smoke evacuation and CO2 recirculation during laparoscopic surgery. Comparative evidence on the use of AirSeal (R) and standard CO2 insufflator in laparoscopic general surgery procedures is scarce. The aim of this study was to compare surgical outcomes between AirSeal (R) and standard CO2 insufflators in patients undergoing the most frequently performed laparoscopic procedures. Methods One hundred and ninety-eight patients undergoing elective laparoscopic cholecystectomy, colorectal surgery and hernia repair were randomized to either AirSeal (R) (group A) or standard pressure CO2 insufflator (group S). The primary endpoints were operative time and level of postoperative shoulder tip pain (Visual Analog Scale). Secondary outcomes included Clavien-Dindo grade complications, surgical side effect and length of hospital stay. Results Patients were randomized to either group A (n = 101) or group S (n = 97) and were analyzed by intention-to-treat. There was no significant difference in mean operative time between the groups (median [IQR]; 71 min [56-94] in group A vs. 69 min [52-93] in group S;p = 0.434). Shoulder tip pain levels were significantly lower in group S (VAS 0 [0-3] in group S vs. 2 [0-4] in group A;p = 0.001). There was no significant difference in complications, surgical side effects (subcutaneous emphysema was not observed in any group) and length of hospital stay. Conclusion This randomized controlled trial showed that using the AirSeal (R) system did not reduce operative time and was associated with a higher postoperative shoulder tip pain compared to standard CO2 insufflator for short elective surgeries. ClinicalTrials.gov (NCT01740011).
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