does any one use LMA ProSeal for laproscopic surgery ?

[dramitshah]

Hi,
I have recently started using LMA for its various applications as it was not easily available in my part of India.
I have used LMA Classic and its equivalent LMA from other company which are available in disposable form also.
I have a very good experience of using LMA for peripheral surgery like orthopedic limb surgeries, neck surgeries including a neck turned to one side and even neck movements were done during surgery without any problems. i have used lma for hysteroscopy , supplementation required during various regional anesthesia when effect wairs off, and two incidence of difficult intubation were patient was successfully ventilated till alternative arrangement were made.
All this cases i have conducted with controlled and spontaneous ventilation without any problems and ease of airway management, patients compliance  and recovery excellent.
Now i have temptation to use this for short gynecological procedures like diagnostic lapro-hysteroscopy and laproscopic tube ligation (sterilization operation) to start with.
company representative  have shown me many references but i am alway sceptical about data shown by company persons.
i would like to have your opinion and experience regarding  use  LMA ProSeal for laproscopic surgery

[yogenbhatt1]

Hi,
Amit,
        First a reply to your asking about using Procele LMA for Lap Tubal Ligation. The law of the land says that Endotracheal Intubation is must. It has got nothing against LMA. It is decided by Health and Family planning department that intubation is mandatory. They go by statistics only. Since it is a national programme, where by the Govt comapnsates a patient in event of mishap, thay have drawn fixed guidelines. Their statistics show that mortality is much higher when tube is not introduced. Hence the law. Do not get tempted.
         All the same this does not apply to other lap surgeries. You can conduct ( I have been doing) diagnostic lap procedures and even a lap appendix or other lap surgeries, preferably with Procele for obvious reason.
        There are centers in Mumbai which have presented a large series of LAVH done only under LMA classic.
But, when we feel that time taken will be grossly long, we prefer intubation.

[Dr. Mian]

Interesting post,

I have a lot of experience with the pLMA, but have never used it for laparoscopic surgery.  Having said that of all the laparoscopic procedures I think lap BTL would be a good candidate (where allowed) as it commonly takes less than 10-15 minutes.  I would not attempt longer or more complicated procedures or non ideal patients unless there are major changes in the standard of care.