Laparoscopic Cholecystectomy

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Introduction

Laparoscopic cholecystectomy is one of the most commonly performed surgical procedures in the world, in fact, it is the most frequent laparoscopic procedure performed. Over one million cholecystectomies are performed in the U.S. annually, with over 96% of those being performed laparoscopically [1].
It is common practice in most of the countries for anesthesia to be carried out with the use of the laryngeal mask airway (LMA), the most important and popular supraglottic airway device (SAD).
This device has several advantages when compared to tracheal intubation (TI), in particular avoidance of complications associated with TI, quick and ease of placement of the airway device itself, a lesser requirement for neuromuscular blockade, …show more content…
The other controversial point is the ability of the LMA to provide correct ventilation in patients undergoing laparoscopic procedures. Laparoscopy is thought to increase the risk of aspiration due to the pneumoperitoneum-induced, which increase intra-abdominal pressure and it is accompanied by high peak airway pressure [5-7] …show more content…
In this position, the LMA create an airway sealing, which permit a correct ventilation of the patient as well as a protection of airway against aspiration. We usually measure this sealing pressure (SP) or oropharyngeal leak pressure (OLP) in order to know how capable the LMA is to protect airway against potential aspiration of gastric contents. Different types of airway Seal pressure tests can be performed using different test, it is commonly done by the anesthetist after general anesthesia induction for assessing OLP with the LMA prior to the beginning of the surgery [9].
The classical Laryngeal Mask Airway (LMA-C) is the most widely studied SAD and in the last 15 years, several devices have been incorporated in order to improve the SAD´s indications, these devices have bigger and better cuff, some of them with gastric access incorporation.
These designs offers a cuff that allows a higher seal pressure than the LMA-C and a drain tube that allows venting of the stomach contents and blind insertion of standard gastric tubes. Therefore, these new generation LMAs provides certain protection against regurgitation and prevents gastric insufflation when correctly placed.
These devices are a reasonable choice when performing anesthesia for procedures
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