The author points out that Second-generation SADs are a safe alternative for laparoscopic surgeries in appropriately selected patients. They are better than the first-generation SADs at protecting against gastric insufflation and aspiration. They also have improved ventilation that is effective even with pneumoperitoneum Anesthesia professionals may need to discontinue the use of first-generation devices in laparoscopic surgery due to the lower oropharyngeal leak pressures and increased incidence of gastric insufflation if improperly sealed. Otherwise, SADs may offer a variety of benefits over ETTs in laparoscopic surgery including improved hemodynamic stability, a reduced risk of perioperative respiratory complications, reduced airway morbidity, and they may even contribute to earlier hospital discharge. Second-generation SADs have many benefits that warrant their use in laparoscopic surgery.

Supraglottic Airway Devices (SADs) and Laparoscopic Surgery - Anesthesia Patient Safety Foundation