Incentive Spirometry and Upper Abdominal Laparoscopic Surgery
Condition: Cholecystitis; Perforated Duodenal Ulcer; Diaphragmatic Hernia; Benign Pancreas Tumor; Malignant Pancreatic Neoplasm; Splenic Infarction; Splenomegaly; Choledocholithiasis; Hiatal Hernia
MeSH terms: Pancreatic Neoplasms; Cholecystitis; Choledocholithiasis; Duodenal Ulcer; Splenic Infarction; Hernias, Diaphragmatic, Congenital; Hernia; Hernia, Diaphragmatic; Hernia, Hiatal; Splenomegaly
Study type: Interventional

Summary: 
      To compare the effects of volume-oriented versus flow-oriented incentive spirometry on
      pulmonary function tests and functional capacity in patients of upper abdominal laparoscopic
      surgery. Previous studies were designed to target only spirometer without focusing on its
      different types and their effects. This study covers the research gap and therefore is
      designed to observe effects of different types of spirometer on pulmonary function of
      patients undergoing upper abdominal laparoscopic surgery.
    

Detailed description: 
      The volume oriented incentive spirometer enables the patient to inhale air through a
      mouthpiece and corrugated tubing which is attached to a plastic bellows. The volume of air
      displaced is indicated on a scale located on the device enclosure. After the patient has
      achieved the maximum volume, the individual is instructed to hold this volume constant for 3
      to 5 seconds.

      Studies suggest a physiologically significant difference in the effect of the flow- and
      volume-oriented incentive spirometer. Flow-oriented devices enforce more work of breathing
      and increase muscular activity of the upper chest. Volume-oriented devices enforce less work
      of breathing and improve diaphragmatic activity.

      Research was carried out a study on two experimental groups of patients in order to evaluate
      the effects of aerobic exercise training and incentive spirometry in controlling pulmonary
      complications following laparoscopic cholecystectomy, results indicated a significant
      reduction in heart rate, Oxygen Saturation of hemoglobin (SaO2), and inspiratory capacity for
      both groups. The researchers concluded that aerobic exercise and incentive spirometry were
      beneficial in reducing the postoperative pulmonary complications after laparoscopic
      cholecystectomy.

      Another study observed the comparative study on the effect of preoperative and postoperative
      incentive spirometry on the pulmonary function of fifty patients who had undergone
      laparoscopic cholecystectomy. The authors concluded that pulmonary function is well-preserved
      with preoperative than postoperative incentive spirometry.

      Another study observed that the volume incentive spirometry resulted in early recovery of
      both pulmonary function and diaphragm movement in patients who undergone laparoscopic
      abdominal surgery.
    

Intervention name(s): Volume-oriented incentive spirometry; Flow-oriented incentive spirometry
Intervention type(s): Other; Other
Intervention description(s): 3 sets of 5 repeated deep breaths using volume oriented incentive spirometry 3 times a day for 2 days; 3 sets of 5 repeated deep breaths using flow oriented incentive spirometry 3 times a day for 2 days
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Flow oriented incentive spirometry; Volume oriented incentive spirometry; Digital spirometer; Six minute walk test; Forced vital capacity (FVC); Forced Expiratory Volume in the first second (FEV1); Upper abdominal laparoscopy