الفهرس 
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Abstract
Obesity is a common health problem, it affects people among developed and developing countries. It carries many co-morbidities and co-mortalities risks. Management is by either medical or surgical approach, bariatric surgery is one of most common approach done by laparoscopy .Laparoscopy is widely used in the surgical treatment of a number of diseases. Its advantages are minimal invasiveness, better cosmetic outcome and shorter length of hospital stay. However, the effects of pneumoperitoneum are particularly relevant to obese patients. Moreover, many surgical procedures are significantly longer in duration when performed with laparoscopic techniques, these factors impose special care for the management of mechanical ventilation during bariatric laparoscopic surgery. Obesity and abdominal insufflations of gas during laparoscopy greatly affects intra-operative respiratory mechanics. This study aimed to assess the impact of pressure controlled ventilation on intraoperative hemodynamics, lung mechanics, oxygenation indices, postoperative pulmonary complications compared to volume controlled ventilation during anesthesia for bariatric laparoscopic surgery 30 patients were randomized into two groups; VC group and PC group. After induction of anesthesia and attachment of proper monitors, All patients were mechanically ventilated through closed circuit with initial settings (Tidal volume 6- 8 ml/Kg of ideal body weight (IBW), RR 12-15 BPM, I:E 1:2, PEEP 5-8 cmH2o, Fio2 0.50). Ventilatory parameters were modified to maintain EtCo2 between 35±2 mmHg. Haemodynamics parameter (HR,SBP,DBP),oxygenation indices (Sao2,Spo2), lung mechanics (compliance,peak airway pressure,mean airway pressure) are collected intraoperative and postoperative for 6 hours (including symptoms and signs of complication) . Data were entered and statistically analyzed. Coinciding with results of many studies, Ventilatory and haemodynamic monitoring during the intraoperative and postoperative periods shows nosignificant differences were found between both studied groups either during the intraoperative or postoperative course. So, we recommend to have an ideal, effective perioperative ventilation strategy including proper patient selection, treatment of chest infection or bronchospasm, use incentive spirometry, proper ventilation adjustment, recruitment maneouver, peep application, prevention of aspiration and post operative ventilator support and analgesia supplementation when dealing with obese patients rather than depending on choosing mode of ventilation.