ArticleSurgical endoscopy2016
Abdominal insufflation for laparoscopy increases intracranial and intrathoracic pressure in human subjects.
Article in Surgical endoscopy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 35 citations in OpenAlex.
- The effects of positive end-expiratory pressure (PEEP) application on optic nerve sheath diameter in patients undergoing laparoscopic cholecystectomy: a randomized trial.Brazilian journal of anesthesiology (Elsevier)Trial
- Multimodal perioperative monitoring of intracranial pressure surrogates and cerebral oxygenation during laparoscopic surgery: implications for early cognitive outcomes.BMC anesthesiology · 2026Observational
- Ultrasound measurement of the optic nerve and its sheath using the CLOSED protocol: comparison with MRI in a porcine in-vivo model.BMC veterinary research · 2026Article
- Intermittent hypobaric pressure induces selective senescent cell death and alleviates age-related osteoporosis.Nature biomedical engineering · 2026Article
- Article
- Mind the gut: Navigating the complex landscape of gastroprotection in neurosurgical patients.World journal of gastroenterology · 2025Article
- Intracranial pressure estimated non-invasively and postoperative outcomes in surgery in the Trendelenburg position with pneumoperitoneum.Journal of anesthesia, analgesia and critical care · 2025Review
- Cesena guidelines: WSES consensus statement on laparoscopic-first approach to general surgery emergencies and abdominal trauma.World journal of emergency surgery : WJES · 2023Article
- Article
- Lung mechanics during video-assisted abdominal surgery in Trendelenburg position: a cross-sectional propensity-matched comparison between classic laparoscopy and robotic-assisted surgery.BMC anesthesiology · 2022Article
- Successful laparoscopic removal of ovarian borderline cystadenoma in patient with multiorgan hemangioma and ventriculoperitoneal shunt: a case report and literature review.Journal of surgical case reports · 2021Article
- Transumbilical single-incision laparoscopically assisted ventriculoperitoneal shunting: a minimal invasive technique.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2021Article
- Basic Fibroblast Growth Factor (bFGF) Protects the Blood-Brain Barrier by Binding of FGFR1 and Activating the ERK Signaling Pathway After Intra-Abdominal Hypertension and Traumatic Brain Injury.Medical science monitor : international medical journal of experimental and clinical research · 2020Article
- A big mesenteric rupture after blunt abdominal trauma: A case report and literature review.International journal of surgery case reports · 2019Article
- Intraperitoneal hypertension, a novel risk factor for sepsis-associated encephalopathy in sepsis mice.Scientific reports · 2018Article
- Laparoscopy in Blunt Abdominal Trauma: for Whom? When?and Why?Current trauma reports · 2017Review
- The use of laparoscopy in managing penetrating thoracoabdominal injuries in Africa: 83 cases reviewed.World journal of emergency surgery : WJES · 2017Article
- Anesthetic considerations for extracranial injuries in patients with associated brain trauma.Journal of anaesthesiology, clinical pharmacologyReview
- Sutureless "Slim-Mesh" Technique for the Repair of Abdominal-Wall Hernias in the Obese Population.JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLaparoscopy has emerged as an alternative to laparotomy in select trauma patients. In animal models, increasing abdominal pressure is associated with an increase in intrathoracic and intracranial pressures. We conducted a prospective trial of human subjects who underwent laparoscopic-assisted ventriculoperitoneal shunt placement (lap VPS) with intraoperative measurement of intrathoracic, intracranial and cerebral perfusion pressures.
methodsTen patients undergoing lap VPS were recruited. Abdominal insufflation was performed using CO2 to 0, 8, 10, 12 and 15 mmHg. ICP was measured through the ventricular catheter simultaneously with insufflation and with desufflation using a manometer. Peak inspiratory pressures (PIP) were measured through the endotracheal tube. Blood pressure was measured using a noninvasive blood pressure cuff. End-tidal CO2 (ETCO2) was measured for each set of abdominal pressure level. Pressure measurements from all points of insufflation were compared using a two-way ANOVA with a post hoc Bonferroni test. Mean changes in pressures were compared using t test.
resultsICP and PIP increased significantly with increasing abdominal pressure (both p < 0.01), whereas cerebral perfusion pressure (CPP) and mean arterial pressure did not significantly change with increasing abdominal pressure over the range tested. Higher abdominal pressure values were associated with decreased ETCO2 values.
conclusionIncreased ICP and PIP appear to be a direct result of increasing abdominal pressure, since ETCO2 did not increase. Though CPP did not change over the range tested, the ICP in some patients with 15 mmHg abdominal insufflation reached values as high as 32 cmH2O, which is considered above tolerance, regardless of the CPP. Laparoscopy should be used cautiously, in patients who present with baseline elevated ICP or head trauma as abdominal insufflation affects intracranial pressure.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.