[The transesophageal echocardiographic evaluation of the hemodynamic effects of the pneumoperitoneum in laparoscopic hemicolectomy].

Materials and Methods: Ten patients undergoing laparoscopic left hemicolectomy were monitored by transesophageal echocardiography in order to assess the effects of pneumoperitoneum and head-down tilt on the following parameters: end-diastolic left ventricular volume, stroke volume, cardiac output, left ventricular ejection fraction, mean blood pressure and cardiac frequency. Pneumoperitoneum, by a mean CO2 pressure of 13 mmHg, was performed in five of them; for the other patients, mechanical abdominal wall suspension was used, without any increase in abdominal pressure.
Results: The group treated by abdominal wall suspension underwent an increase in end-diastolic left ventricular dimension, stroke volume, cardiac output and blood pressure, while the group treated by pneumoperitoneum had no significant changes in hemodynamic parameters.
Conclusions: In this surgical context, pneumoperitoneum seems to be safe and to have a low hemodynamic impact, as its effects on venous return seem to be opposite to those of the Trendelenburg position.