Which intraperitoneal insufflation pressure should be used for less postoperative pain in transperitoneal laparoscopic urologic surgeries?

ABSTRACT Purpose To determine whether using different intraperitoneal insufflation pressures for transperitoneal laparoscopic urologic surgeries decreases postoperative pain. Materials and Methods 76 patients who underwent transperitoneal laparoscopic upper urinary tract surgery at different insufflation pressures were allocated into the following groups: 10mmHg (group I, n=24), 12mmHg (group II, n=25) and 14mmHg (group III, n=27). These patients were compared according to age, gender, body mass index (BMI), type and duration of surgery, intraoperative bleeding volume, postoperative pain score and length of hospital stay. A visual analog scale (VAS) was used for postoperative pain. Results Demographic characteristics, mean age, gender, BMI and type of surgeries were statistically similar among the groups. The mean operation time was higher in group I than group II and group III but this was not statistically significant (P=0.810). The mean intraoperative bleeding volume was significantly higher in group I compared with group II and group III (P=0.030 and P=0.006). The mean length of postoperative hospital stays was statistically similar among the groups (P=0.849). The mean VAS score at 6h was significantly reduced in group I compared with group III (P=0.011). At 12h, the mean VAS score was significantly reduced in group I compared with group II and group III (P=0.009 and P<0.001). There was no significant difference in the mean VAS scores at 24h among three groups (P=0.920). Conclusion Lower insufflation pressures are associated with lower postoperative pain scores in the early postoperative period.

Which intraperitoneal insufflation pressure should be used for less postoperative pain in transperitoneal laparoscopic urologic surgeries?

PURPOSE: To determine whether using different intraperitoneal insufflation pressures for transperitoneal laparoscopic urologic surgeries decreases postoperative pain. MATERIALS AND METHODS: 76 patients who underwent transperitoneal laparoscopic upper urinary tract surgery at different insufflation pressures were allocated into the following groups: 10mmHg (group I, n=24), 12mmHg (group II, n=25) and 14mmHg (group III, n=27). These patients were compared according to age, gender, body mass index (BMI), type and duration of surgery, intraoperative bleeding volume, postoperative pain score and length of hospital stay. A visual analog scale (VAS) was used for postoperative pain. RESULTS: Demographic characteristics, mean age, gender, BMI and type of surgeries were statistically similar among the groups. The mean operation time was higher in group I than group II and group III but this was not statistically significant (P=0.810). The mean intraoperative bleeding volume was significantly higher in group I compared with group II and group III (P=0.030 and P=0.006). The mean length of postoperative hospital stays was statistically similar among the groups (P=0.849). The mean VAS score at 6h was significantly reduced in group I compared with group III (P=0.011). At 12h, the mean VAS score was significantly reduced in group I compared with group II and group III (P=0.009 and P<0.001). There was no significant difference in the mean VAS scores at 24h among three groups (P=0.920). CONCLUSION: Lower insufflation pressures are associated with lower postoperative pain scores in the early postoperative period.

Impact of cadaveric surgical anatomy training on urology residents knowledge: a preliminary study.

OBJECTIVE: Cadaveric dissection is used as a major tool for anatomy education at the medical school. In this study we aimed to determine how a uro-anatomy cadaveric dissection course would impact urology residents knowledge. MATERIALS AND METHODS: A three days course was given to 50 urology residents by experienced trainers in 1-3 June 2012 at Ege University Medical School's Anatomy Department, Izmir, Turkey. Efficacy of the course was assessed using a multiple choice questionnaire of 20 questions given before and after the course. RESULTS: Completed questionnaires before and after the course were available for 25 residents (50%) that were included. Residents answered correctly to 11.7 out of 20 questions (59%) before the course and 13.0 out of 20 (65%) after (p<0.05). In individuals analysis, 16 residents (64%) increased their scores, 4 (16%) had similar scores and 5 (20%) had lower scores. The number of correct answers for 6 out of the 20 questions was lower following the course. CONCLUSION: This cadaveric surgical anatomy course was effective in improving surgical anatomy knowledge for most urology residents but not all and helped to identify ways to improve the course in the future.