الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The laparoscopic approach has become a common technique for many types of surgical procedures, including gynecology, general surgery, and urology. It aims to minimize the trauma of the interventional process.
Advantages of these procedures include smaller incisional sites, lower risks of wound complications, reduced postoperative pain and complications, improved recovery, shorter hospital stays, more rapid return to normal activities, and significant cost savings.
During gas insufflation [pneumoperitoneum (PP)], increased intra-abdominal pressure (IAP) can cause decreased venous return, cardiac output , increased heart rate, mean arterial pressure, and systemic vascular resistance , Moreover, carbon dioxide (CO2) gas insufflation can cause hypercapnia and respiratory acidosis due to absorption of the gas across the peritoneal surface.
Trendelenburg positioning causes an increase in intracranial pressure (ICP) due to increased venous pressure, which hinders cerebral venous drainage with a consequential increase in the cerebral blood volume.
The earliest recognition of raised ICP is therefore of obvious and chief importance so that it can be monitored and so that therapies can be started in order to lower ICP. A raised ICP is measurable both clinically and quantitatively. Continuous ICP monitoring is important both for assessing the efficacy of therapeutic measures and for evaluating the progression of brain insult.
Ocular sonography has been used to measure the changes in ONSD to detect raised ICP, and it has been clinically shown that millimetric increases in the Sonographic ONSD correspondstoincreasedICP.
Our study was conducted at Surgical Operating Theatre in Suez Canal University Hospitals on 20 patients undergoing elective Laparoscopic gynecological surgeries with no history of any neurological disorder or risk factors of high ICP after approval of hospital ethics committee and written informed patient consent-taken.
In our study ONSD in both right and left eyes rose up significantly after insufflation, and didn’t return to non-significantly different values until 30 min. after extubation.