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Purpose <p>Insufflation of the abdomen during laparoscopy aims to create adequate operative space and visualisation of the structures. However, higher pressures have been associated with more ventilation issues, higher post-operative pain and extended post-operative recovery, and this appears more marked in the paediatric population.</p> <p>There is currently no consensus for paediatric insufflation pressures and surgeons have adapted practice based on their experience. We aimed to review our practice to ensure safe paediatric laparoscopy.</p> Methods <p>A single-centre prospective review of paediatric laparoscopic cases was conducted in 2023–2024. Patient demographics, surgical pathology, surgeon grade and the pressures and flow used during the procedure were recorded.</p> Results <p>Twenty-five cases over a four-month period were assessed with a median age of 3&#xa0;years (range 2&#xa0;months -13&#xa0;years) and weight of 11.1 (4.4–48) kg. Median initial pressure was 9 (8–12) mmHg and initial flow 2 (1–5) l/min. There were intra-operative changes in four patients, two increased pressure (8 to 10 and 12 to 15&#xa0;mmHg), one decreased pressure (8 to 4&#xa0;mmHg) and one increased flow (2 to 4&#xa0;l/min). The most common operations in the cohort were laparoscopic inguinal hernia repair (12, 50%) and laparoscopic appendicectomy (6, 25%). There were no complications from laparoscopy in this patient cohort.</p> Conclusion <p>Current practice has shown that paediatric pressures were appropriate, tailored to age and weight and were consistent across different surgeons and procedures. Continued awareness of potential harms when using higher pressures in paediatric laparoscopy needs to be highlighted.</p>

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Single centre prospective review of paediatric laparoscopy pressure and flow

  • 期刊论文

  • 发表日期：

    2025年10月1日

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  • Vanessa Coles,
  • Sarah Driscoll,
  • Amulya Saxena

摘要

Purpose

Insufflation of the abdomen during laparoscopy aims to create adequate operative space and visualisation of the structures. However, higher pressures have been associated with more ventilation issues, higher post-operative pain and extended post-operative recovery, and this appears more marked in the paediatric population.

There is currently no consensus for paediatric insufflation pressures and surgeons have adapted practice based on their experience. We aimed to review our practice to ensure safe paediatric laparoscopy.

Methods

A single-centre prospective review of paediatric laparoscopic cases was conducted in 2023–2024. Patient demographics, surgical pathology, surgeon grade and the pressures and flow used during the procedure were recorded.

Results

Twenty-five cases over a four-month period were assessed with a median age of 3 years (range 2 months -13 years) and weight of 11.1 (4.4–48) kg. Median initial pressure was 9 (8–12) mmHg and initial flow 2 (1–5) l/min. There were intra-operative changes in four patients, two increased pressure (8 to 10 and 12 to 15 mmHg), one decreased pressure (8 to 4 mmHg) and one increased flow (2 to 4 l/min). The most common operations in the cohort were laparoscopic inguinal hernia repair (12, 50%) and laparoscopic appendicectomy (6, 25%). There were no complications from laparoscopy in this patient cohort.

Conclusion

Current practice has shown that paediatric pressures were appropriate, tailored to age and weight and were consistent across different surgeons and procedures. Continued awareness of potential harms when using higher pressures in paediatric laparoscopy needs to be highlighted.