HEMOSTATIC CHANGES INDUCED BY CARBOXYPERITONEUM DURING LAPAROSCOPIC SLEEVE GASTRECTOMY IN PATIENTS WITH MORBID OBESITY
DOI:
https://doi.org/10.32782/2411-9164.21.2-11Keywords:
bariatrics, thrombosis, hemostasis, obesity, thromboelastographyAbstract
This article highlights the issue of venous thromboembolism (VTE) as a serious complication following bariatric surgeries in patients with morbid obesity. The analysis covers the mechanisms by which obesity becomes a prothrombotic state, particularly its impact on platelet activity, coagulation, and fibrinolysis. Key bariatric procedures such as laparoscopic adjustable gastric banding (LAGB), Roux-en-Y gastric bypass (RYGBP), biliopancreatic diversion (BPD), and sleeve gastrectomy (SG) are discussed. Special attention is given to the effect of pneumoperitoneum, used during laparoscopic surgeries, on the development of VTE. The standard pressure of pneumoperitoneum is 11–13 mm Hg, but in certain cases, elevated pressure ≥16 mm Hg is applied, which significantly increases the risk of thromboembolic complications. The article discusses the results of hemostatic potential (HP) assessment in patients using low-frequency piezoelectric thromboelastography (LF-TEG). It is shown that increased pneumoperitoneum pressure significantly affects coagulation and fibrinolysis, leading to a heightened risk of thrombosis. The conclusions emphasize the importance of controlling pneumoperitoneum levels and closely monitoring the hemostatic system to minimize VTE risks in obese patients undergoing bariatric surgeries.
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