To investigate the application of 6mmHg (1 mmHg=0.133 kPa) pneumoperitoneum pressure in laparoscopic total extraperitoneal hernia repair (TEP).

In the first stage, 60 non elderly patients with unilateral indirect inguinal hernia and good cardiopulmonary function and less than 75 years old were randomly divided into group A and B, with 30 patients in each group. The pneumoperitoneum pressure in group A was set at 14mmHg, and that in group B was set at 6mmHg. The satisfaction of the surgical field of surgeons, the operation time, the pneumoperitoneum time, the airway pressure at different time points during the anesthesia period, the end expiratory PaCO₂, the discharge time, and the incidence of surgical complications were compared between the two groups.

There was no significant difference in hospital stay among the three groups (P>0.05). In terms of the operation time and pneumoperitoneum time, compared with group A, group B and group C were slightly longer, the difference was statistically significant (P<0.05), and there was no significant difference between group B and group C (P>0.05). The satisfaction with surgical field in group A (4.30±0.65) points was significantly higher than that in group B (4.28±0.63) points (P<0.05). The satisfaction with surgical field of group A was better than that of group C (4.42±0.64) points, the difference was statistically significant (P<0.05). There was no significant difference in satisfaction wi points h surgical field between group B and group C (P>0.05). There was no significant difference in the incidence of postoperative complications among the three groups (P>0.05). The paw and PetCO₂ of T1, T2 and T3 in the three groups were significantly different from that of the same group of T0 (P<0.05). The paw and PetCO₂ of T1, T2 and T3 in group B and C were significantly different from those in group A (P<0.05). There was no significant difference in other indexes (P>0.05).

For some elderly patients with poor cardiopulmonary function such as chronic bronchiolitis and emphysema, TEP with 6 mmHg low abdominal pressure can definitely reduce the intraoperative airway pressure and end respiratory PaCO₂, and increase the safety and tolerance of the operation. Although it slightly affects the operation field and space, it does not affect the smooth completion of the operation, and the incidence of postoperative complications and discharge time are not significantly affected.