A Technique to Reduce Trendelenburg Degree during Gynaecological Laparoscopic Surgeries

Abstract

The trendelenburg position in awake and anaesthetised patient’s increases Pulmonary Arterial Pressures (PAP), Central Venous Pressure (CVP) and Pulmonary Capillary Wedge Pressure (PCWP). Trendelenburg position in laparoscopic surgeries generally increases venous return and Cardiac Output. If the patient is placed in extreme trendelenburg, a decrease in venous return from the head may result, thus leading to increased intracranial and intraocular pressures. If this position is maintained for an extended duration, cerebral edema and retinal detachment may occur. Because of venous stagnation, cyanosis and edema in the face and neck may be expected. Hence, our study aims to demonstrate a new technique which can help to reduce the angle degree of trendelenburg position, thereby reducing the adverse effects of prolonged decreased venous return from the head, like increased intracranial and intraocular pressures, cyanosis or oedema of the face.