ОСОБЕННОСТИ ЛАПАРОСКОПИЧЕСКИХ ОПЕРАЦИЙ В ГИНЕКОЛОГИИ С ИСПОЛЬЗОВАНИЕМ АТМОСФЕРНОГО ВОЗДУХА ДЛЯ СОЗДАНИЯ НИЗКОГО ДАВЛЕНИЯ ПНЕВМОПЕРИТОНЕУМА В СРАВНЕНИИ С УГЛЕКИСЛЫМ ГАЗОМ
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laparoskopiya##common.commaListSeparator## ginekologiya##common.commaListSeparator## pnevmoperitoneum##common.commaListSeparator## karbonat angidridAbstrak
Ginekologik amaliyotga laparoskopiya kiritilgandan beri, qorin bo'shlig'i ichidagi bosimi 12-15 mm simob ustuni bo'lgan karbonat angidrid (CO₂) pnevmoperitoneum operatsiya maydonini yaratish uchun "oltin standart" bo'lib qolmoqda. Biroq, yuqori samaradorligiga qaramay, bu usul CO₂ ning fizik-kimyoviy xususiyatlari (giperkapniya, atsidoz) va yuqori bosim (qon tomirlarining siqilishi, venoz qaytishning pasayishi) bilan bog'liq bir qator tizimli ta'sirlar bilan bog'liq. So'nggi yillarda muqobil insufflyatsiya usullariga, xususan, past bosimda (6-8 mm simob ustuni) atmosfera (xona) havosidan foydalanishga qiziqish qayta tiklandi. Laparoskopiyaning dastlabki kunlarida mashhur bo'lgan bu yondashuv yana bir bor anesteziya xavfini kamaytirish va perioperativ natijalarni yaxshilash usuli sifatida o'rganilmoqda.
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1. Yang X, Cheng Y, Cheng N, Gong J, Bai L, Zhao L, Deng Y. Gases for establishing pneumoperitoneum during laparoscopic abdominal surgery. // Cochrane Database Syst Rev. 2022;3:CD009569. doi:10.1002/14651858.CD009569.pub4
2. Ikechebelu J.I., Obi R.A., Udigwe G.O., Joe-Ikechebelu N.N. Comparison of carbon dioxide and room air pneumoperitoneum for day-case diagnostic laparoscopy.// J Obstet Gynaecol. 2005;25(2):172-173. doi:10.1080/01443610500051528
3. Khandwala S.D. Development of a simplified laparoscopic sterilization technique. // J Reprod Med. 1984;29(8):586-588. PMID: 6237198
4. Menes T, Spivak H. Laparoscopy: searching for the proper insufflation gas. // Surg Endosc. 2000;14(11):1050-1056. doi:10.1007/s004640000216
5. Skorzyński W, et al. Haemodynamics during gynaecological laparoscopy // Anestezjol Intens Ter. 2008;40(1):7-12. PMID: 19469091
6. Hirvonen, E., Nuutinen, L.S., & Kauko, M. (1995). Hemodynamic changes due to Trendelenburg positioning and pneumoperitoneum during laparoscopic hysterectomy. // Acta Anaesthesiologica Scandinavica, 39.
7. Mularski RA, et al. Pneumoperitoneum: a review of nonsurgical causes. // Crit Care Med.
8. Kim D.K., Cheong I.Y., Lee G.Y., Cho J.H. Low Pressure (8 mmHg) Pneumoperitoneum Does Not Reduce the Incidence and Severity of Postoperative Nausea and Vomiting (PONV) Following Gynecologic Laparoscopy. // Korean J Anesthesiol. 2006;50:S36-S42.
9. Giorgi M., Schettini G., La banca L., Cannoni A., Ginetti A. Prevention and Treatment of Intraoperative Complications During Gynecological Laparoscopic Surgery: Practical Tips and Tricks—A Narrative Review. // Adv Ther. 2025;42(5):2089-2117. doi:10.1007/s12325-025-03165-z
10. Inderbitzin D.T., Mueller T.U., Marti G., et al. Severe portal and systemic acidosis during CO2-laparoscopy compared to helium or gasless laparoscopy and laparotomy in a rodent model: an experimental study. // Surg Endosc. 2022;36(7):4701-4711. doi:10.1007/s00464-021-08810-6
11. Milki A.A., Tazuke S.I. Comparison of carbon dioxide and air pneumoperitoneum for gamete intrafallopian transfer under conscious sedation and local anesthesia. // Fertil Steril. 1998;69(3):552-554. doi:10.1016/s0015-0282(97)00541-4
12. Stone J, Dyke L, Fritz P, et al. Hemodynamic and hormonal changes during pneumoperitoneum and trendelenburg positioning for operative gynecologic laparoscopy surgery. // Prim Care Update Ob Gyns. 1998;5(4):155. doi:10.1016/s1068-607x(98)00043-2
13. Chen L, Dasgupta P, Vasdev N. Use of mixed gas pneumoperitoneum during minimally invasive surgery: a systematic review of human and mouse modelled laparoscopic interventions. // J Robot Surg. 2024;18(1):215. Published 2024 May 17. doi:10.1007/s11701-024-01971-1
14. Ikechebelu J.I., Okeke C.A. Improving the safety of room air pneumoperitoneum for diagnostic laparoscopy. // Niger J Clin Pract. 2008;11(2):127-129.
15. Goldberg J.M., Falcone T. Gasless Gynecologic Laparoscopy. // Contemporary OB/GYN. 2026.
16. Petker S, Ahmed G. Asystolic Cardiac Arrest Following Pneumoperitoneum From Vagal-Mediated Bradycardia During Laparoscopic Gynaecologic Surgery: A Case Report. // Cureus. 2025;17(7):e88889. Published 2025 Jul 28. doi:10.7759/cureus.88889
17. Melemeni A, Tympa Grigoriadou A, Tsaroucha A. Free air after laparoscopic hysterectomy; from sigmoid perforation to upper airway compromise: a case report. // J Med Case Rep. 2021;15(1):21. Published 2021 Jan 25. doi:10.1186/s13256-020-02627-y
