Pneumoperitoneum and Gynecological Laparoscopic Surgery: An Observational Clinical Study

Impact Of Posture and Prolonged Pneumoperitoneum on Intra-Operative and Postoperative Outcomes During Gynecological Laparoscopic Surgery: An Observational Clinical Study

Laparoscopic surgery is now widely established.Laparoscopic surgery involves insufflation of a gas (usually carbon dioxide) into the peritoneal cavity producing a pneumoperitoneum. The raised intra-abdominal pressure of the pneumoperitoneum, alteration in the patient's position and effects of carbon dioxide absorption cause changes in physiology, especially within the cardiovascular and respiratory systems.

The study will be carried out after approval of the ethical committee of Faculty of Medicine, Assiut University. A full preoperative anesthetic assessment will be carried out. Particular attention to the cardiovascular and respiratory systems is essential because of potential effects of the pneumoperitoneum and patient position.

Inclusion Criteria:

1. Age range 18-50
2. ASA 1
3. Elective gynecological laparoscopic surgery

Exclusion Criteria:

1. Severe ischemic or valvular heart disease
2. Increased intracranial pressure (e.g. Hydrocephalus, Cerebral tumor, Head injury)
3. Hepatic or renal impairment
4. Emergency surgery
5. Open surgery
6. Previous abdominal surgery