Ventilatory Management Using Electrical Impedance Tomography in an Obese Patient Undergoing Robot-Assisted Laparoscopic Rectal Resection:A Case Report

This study focused on ventilatory management during robot-assisted laparoscopic rectal resection in an obese patient, using electrical impedance tomography (EIT) to evaluate lung conditions. The case involved a 40s male with a history of smoking, obesity (BMI:31), and iodine allergy. General anesthesia was induced, and EIT was employed to assess positive end expiratory pressure (PEEP) during different surgical positions. The study found that the PEEP for supine positioning was 10-12 cmH2O for ventilatory conditions in which the anterior and posterior impedance changes were equal in patients, but during pneumoperitoneum and head lowering, a higher PEEP of 20 cmH2O was necessary to prevent lung collapse. This differed from conventional recommendations. Oxygenation was maintained, and the patient had no major complications. The study suggests that EIT may offer a noninvasive and bedside approach to evaluating ventilator settings, potentially changing perspectives on intraoperative ventilator management. J. Med. Invest. 72 : 447-450, August, 2025.