Effects of Different Intraabdominal Pressure Values on Internal Jugular Vein, Liver and Kidney Functions in Obese Patients Undergoing Laparoscopic Sleeve Gastrectomy

Objective: The aim of this study was to investigate whether there was a difference in LSG performed with 10 mmHg and 13 mmHg intraabdominal pressure values in terms of their effects on the internal jugular vein (IJV) diameter and volume and the results of liver and kidney function tests evaluated in blood. Material and Method: The patients were divided into two groups to apply LSG with 10 mmHg and 13 mmHg intraabdominal pressure. The patients’ age, additional disease, surgery history, height, weight, body mass index, family history, intraabdominal pressure value applied during surgery, duration of surgery, length of hospital stay, and the right IJV diameter and volume on the Doppler ultrasound before intubation during surgery (t1), 10 minutes after insufflation (t2), and at the end of insufflation (t3) were recorded. Results: Preoperative and postoperative kidney and liver function values of the patients in both groups were within the reference range. In both groups, while there was a significant decrease in the IJV diameter and flow measurement values at t2 compared to t1, and a significant increase was observed at t3 compared to t2 (p<0.05). The mean IJV diameter and flow were significantly higher in the 10 mmHg pressure group compared to the 13 mmHg group (p<0.05). Conclusion: We consider that LSG performed with CO2 pneumoperitoneum at low pressure is a safe, effective and feasible method that can facilitate the application of intraoperative central venous catheterization due to less changes in the IJV diameter and volume compared to the standard technique.