Airseal During Laparoscopic Radical Prostatectomy and Regional Extended Lymphadenectomy: Intraoperative Advantage

Materials and methods: 77 consecutive patients underwent t-LRP. The last 38 patients treated using Thermoflator (group A) have been compared with the first 39 patients treated using Airseal (group B). Mean intrabdominal pressure was mantained at 12 mmHg in all patients. Baseline tidal, minute ventilation and positive end expiratory pressure (PEEP) were set at 8 ml/Kg, 10 breaths/minute and 5 cm H20 respectively in both groups. End-tidal CO2 and arterial blood gas analysis were monitored during surgery. Changes of the baseline mechanical ventilator parameters have been made in the case of et CO2 greater than 40 mmHg. Results: Mean introperative et CO2 was 38.21 mmHg in group A and 39.28 mmHg in group B. Baseline mechanical ventilator paramethers had to be modified in 21/38 group A patients and in 5/39 group B patients (p<0.01). These changes allowed to maintain the et CO2 within 40 mmHg in all patients of both groups. Discussion Laparoscopic urological interventions were always demanding procedures. It was true in most particular way during learning curve. Duration of anaesthesiology time should be taken in account for planning. AirSeal insufflator could be an useful device in order to reduce anesthesiologic implication.