Objective:The aim of study was to find if LMA-ProSeal™ safely protects the airways during laparoscopic surgery. Type of study: Prospective study. Setting: Department of Anaesthesiology and Intensive Care, University Hospital. Materials and methods: Patients undergoing elective laparoscopic cholecystectomy were enrolled in the study. The results are presented as the median and the inter-quartile range, the statistical significance was evaluated by Mann-Whitney U Test and Wilcoxon match paired test. Results: Ninety-seven patients (M:F 35:62) aged 54 (37–64) years of age with body mass index (BMI) 26 (23–29) kg . m-2 were enrolled in the study. Twenty-one patients (22%) were classed as severely obese (BMI > 30 kg . m-2). PLMA was inserted on the first attempt in 75 cases (77%), on the 2nd attempt in 14 patients (14%) and in the remaining 8 (8%) patients the insertion was successful on the 3rd attempt after a change of size of the PLMA. The PLMA cuff pressure was 40 (35–40) cm H2O at the beginning of surgery; the capnoperitoneum pressure reached 13 (12–14) mm Hg. Peak airway pressure at the beginning of surgery (Pstart) was 17 (15–21) cm H2O and increased to 22 (19–25) cm H2O after CO2 insufflation (Pcapno). Patients with BMI > 30 had higher Pstart [21(16–23) vs 17(14–20) cm H2O; p = 0.002] and Pcapno [25 (22–30) vs 22 (19–25) cm H2O; p = 0.001]. The difference between Pstart and Pcapno was also significant (p < 0.001). A nasogastric tube was successfully inserted on the 1st attempt in 99% of patients. In one patient a ”foldover” position was revealed. No gastric contents were found in 40 (41%) patients at the end of surgery; in the remaining patients a residuum of 20 ml (10–30 ml) was detected. Regurgitation of gastric juices occurred in 3 patients. No signs of lung aspiration were found. Conclusion: PLMA is a safe method of airway protection during laparoscopic surgery.

        Key words: laparoscopic cholecystectomy – inspiratory pressure – regurgitation – pulmonary aspiration – laryngeal mask