Flow-Controlled Ventilation in Laparoscopic Surgery: A Case Series

Laparoscopic surgery in obese patients and robotic procedures in steep Trendelenburg position impairs ventilation and increases postoperative pulmonary complications. Flow-controlled ventilation (FCV) is a ventilation mode that may improve lung mechanics and gas exchange. We report ventilatory and gas exchange effects of FCV in four patients: two with class III obesity having bariatric surgery and two undergoing robotic urological procedures. FCV enabled compliance-guided lung recruitment with increased tidal volumes and PaO2/FiO2 ratios. No patient developed respiratory complications. This case series suggests FCV may be particularly beneficial in patients with markedly altered respiratory mechanics during laparoscopic or robotic surgery.