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OR in the News (selected articles)

Hasirci I, Elutas E, Polat A, Harb A, Tire Y, A K: Comparison of extraperitoneal and intraperitoneal laparoscopic procedures for intracranial pressure increase: a prospective clinical study. Eur Rev Med Pharmacol Sci 2023; 27: 6207-6214

August 21, 2023

According to the literature, higher levels of both intracranial pres- sure (ICP) and intraabdominal pressure (IAP) are related in a way that suggests a causal relation- ship. An increase in ICP can cause major neuro- logical problems both during and after laparo- scopic surgery. In this study, we aimed to exam- ine the increase in ICP between totally extraper- itoneal (TEP) inguinal hernia repair and laparo- scopic cholecystectomy.
We investigated 52 individuals who underwent laparoscopic sur- gery for the treatment of inguinal hernia (n = 26) or had a laparoscopic cholecystectomy (n = 26). The optic nerve sheath diameter (ONSD) was as- sessed before the procedure (T0), 10 minutes af- ter carbon dioxide insufflation (T1), and immedi- ately before extubation (T2).
There were significant differences in the ONSD values between the two groups as a function of time (p = 0.001). In terms of ONSD, the laparoscopic cholecystectomy value (LV) group showed a greater shift from T0 to T1 and T2 than the inguinal hernia value (HV) group. At T1, the ONSD values of both groups were con- siderably higher than those of T0 and T2. The impact of the extraperitoneal and transperitone- al laparoscopic methods on ICP was investigat- ed. The ONSD value reached its maximum at T1 in both groups. At all measurement periods, the ONSD values of the LV group were noticeably higher than those of the HV group.
The diagnostic accuracy of ONSD ultrasonography is an important ap- proach for determining the ICP level. During the decision-making process of TEP inguinal hernia repair, this study can guide medical profession- als in the evaluation of elevated ICP.