You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is Physiological changes seen in laparoscopy include all except: and explain in detail?
Ans: D. Increased pH(Ref Bailey 27/e p87, 26/e p94,. http://www.laparoscopyhospitaLcom/physiological-changes!laparasconyhtm1)Metabolic acidosis (decrease pH) from CO, absorption is the primary derangement with laparoscopy.Laparoscopy:In laparoscopic surgeries, rigid endoscope introduced through a sleeve into peritoneal cavity.Needle used for pneumoperitoneum: Veress needle.Most commonly used gas: CO2.Physiological Effects of LaparoscopyCardiovascularIncreased intra-abdominal pressure a | CVP, | PCWP, | SVR & | MAP a | Preload &| afterload a decreasing cardiac output.PulmonaryCephalad shift of diaphragm decreases FRC, chest wall compliance and tidal volume increasing the work of breathing.RenalIncreased IAP decreases renal flow, decreasing GFR & reduced urine output.Raised pCO2 leads to RAAS stimulation. No long-term change in GFR/UO.GastrointestinalDecreased perfusion to intestines and stomach (as a result of increase IAP) decreases pHDecreased poal and hepatic flow leads to elevation of LFTs.Peripheral vascularIncidence of DVT, PE is generally lower post-laparoscopic procedures probably secondary to improved prophylaxisRisk is increased with longer procedures and reverse Trendelenberg position.