Introduction. The effect of retropneumoperitoneum on the cardiovascular system, peripheral blood flow and the potential risk of thrombotic complications has not been adequately studied.
Aim. To assess changes in systemic hemodynamics during minimally invasive retroperitoneal procedures, carried out with use of retropneumoperitoneum.
Materials and methods. A total of 120 males and females, aged from 40 to 60 years, were undergone to a retroperitoneoscopic procedures for renal cysts. The parameters of systemic hemodynamics and the presence of edema of the lower extremities under various modes of retropneumoperitoneum were studied.
Results. There was an increase in lateral arterial pressure by 10%, a decrease in cardiac output by 20%, a cardiac index by 24% and a stroke volume by 11%, a decrease in the linear blood flow velocity by 17%, an increase in total peripheral vascular resistance by 12% in patients who underwent the longest procedure using the highest gas pressure in the retroperitoneal space. There was a significant increase in the circumference of the right leg, more than 1.5 cm. On the 7th day after the surgery, the edema on the lower extremities was completely absent.
Conclusion. Retroperitoneoscopic procedures have a significant effect on the cardiovascular system, and can lead to the development of thromboembolic complications.

Keywords: asymmetric edema, retroperitoneum, retroperitoneoscopy, blood pressure