Renal physiology - Laparoscopic considerations

The pneumoperitoneum used for laparoscopic surgery is associated with a myr iad of physiologic changes. An understanding of the effect of elevated intr a-abdominal pressure on cardiopulmonary, vascular, and renal functions is i mportant as the complexity of the laparoscopic urologic procedures continue s to increase. Oliguria and anuria are well-recognized clinical signs of el evated intra-abdominal pressure. The etiology is multifactorial, emanating from vascular and parenchymal compression, and associated with systemic hor monal effects. It is important for the entire operative team to have an und erstanding of the physiologic effects of CO2 insufflation to provide approp riate intraoperative monitoring and management and minimize intraoperative and postoperative complications.