Current Concepts in Intraoperative Ventilation during Anesthesia for Laparoscopic and Robot–Assisted Surgery – a Narrative Review

Journal article : Review

Purpose of Review: Laparoscopic and robot–assisted procedures have become preferred over open abdominal surgery due to their numerous benefits, such as reduced postoperative pain, lower infection risk, and quicker recovery. However, these techniques pose unique challenges for intraoperative ventilation due to the need for CO2 insufflation to create a pneumoperitoneum and specific patient positioning, both of which adversely affect respiratory mechanics. This narrative review aims to summarize these challenges and describes current strategies to overcome them. Recent Findings: Implementing lung–protective ventilation with low tidal volumes and personalized PEEP, along with measures to reduce mechanical power of ventilation, have been shown to reduce postoperative pulmonary complications (PPCs). Summary: Effective and safe intraoperative ventilation during laparoscopic and robot–assisted surgery requires a nuanced understanding of respiratory mechanics and tailored ventilation strategies. Lung-protective ventilation is crucial for minimizing lung injury and optimizing patient outcomes.

Authors: Jimenez-Santana, JD; Díaz-Cambronero, O; Schultz, MJ; Mazzinari, G

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Springer
• Journal: Current Anesthesiology Reports
• Volume: 14
• Issue: 4
• Pages: 534-550
• Publication date: 2024-09-04
• Acceptance date: 2024-08-09
• DOI: 10.1007/s40140-024-00648-7
• EISSN: 2167-6275
• Language: English
• Keywords: Positive end–expiratory pressure (PEEP); Robotic surgery; Laparoscopic surgery; Lung protective ventilation
• Subtype: Review