Impact of Low Pressure Pneumoperitoneum on Postoperative Ileus and Gastrointestinal Dysfunction in Patients Undergoing Laparoscopic Large Bowel Surgery

What this Trial Is About

Researchers are evaluating the effects of different pressures used during laparoscopic large bowel surgery on postoperative ileus and bowel function recovery. This study focuses on adult patients undergoing laparoscopic right hemicolectomy or sigmoid resection. The goal is to understand how high or low intraperitoneal pressure and pressure variations impact the duration of postoperative ileus, time to hospital discharge, and gastrointestinal dysfunction after surgery. Both the type of gas insufflation device and neuromuscular blockade reversal drugs are being studied as part of this research. Participants are randomly assigned to one of five groups that differ by pneumoperitoneum pressure level (high at 15 mmHg or low at 8-12 mmHg), type of insufflation device (AirSeal® device or standard Olympus device), and neuromuscular blockade depth and reversal drug used. High pressure groups use moderate neuromuscular blockade reversed with either neostigmine or sugammadex, while low pressure groups use deep neuromuscular blockade reversed with sugammadex. The study will monitor intrabdominal pressure changes throughout surgery and compare outcomes across these arms. During the study, participants will have their recovery monitored up to 30 days after surgery, including time to gastrointestinal function recovery and readiness for hospital discharge. Clinical data will be collected from medical charts and biological samples taken during surgery, such as peritoneal lavage fluid, serum, and bowel tissue. Researchers will analyze inflammatory markers and perform various laboratory tests to explore mechanisms related to postoperative ileus. Safety and effects on hemodynamic and respiratory parameters during surgery will also be recorded.

Low Pressure Pneumoperitoneum and Postoperative Ileus