[Circulatory mechanics in intra- and extraperitoneal CO2 insufflation in minimally invasive procedures. The effects of a low pressure system]

Abstract

Several studies have addressed the cardiovascular effects of intraperitoneal carbon dioxide insufflation and increased intraabdominal pressure. The pathophysiology of this intervention is complex. Reported results apparently differ depending on which patients are studied and are affected by blood volume and/or positioning. With the Starling resistor concept of abdominal venous return in which, analogous to pulmonary vascular zones, flow through the inferior vena cava is considered a function of the pressure difference between upstream venous and either abdominal pressure or downstream intrathoracic caval vein pressure, different results reported in literature can be reconciled.