TRENDELEMBURG POSITION

There are changes in the position of the patient, which passes the trendelemburg (when establishing pneumoperitoneum), laparoscopic cholecystectomy to Trendelemburg invested (to the dissection of the gallbladder), thus avoiding the cavity injuries and providing an adequate exposure of the surgical site. The position with the head down conditions a head displacement of the abdominal viscera and diaphragm. Therefore it is another factor affecting the decrease of the residual functional capacity, total lung volume and pulmonary compliance. There may also be a head displacement of the trachea and tree tracheobronchial compared to endotracheal tube, which can lead to the migration of it towards the right bronchus. Changes of position can influence an increase of the mean arterial blood pressure, central venous pressure, and cerebrospinal fluid pressure.