Anaesthesia for laparoscopic surgery.

Laparoscopic surgery offers patients a significant number of advantages, including a reduction in pain and cosmetic injury that facilitates early ambulation and a rapid return to normal activities. Although the surgery is of a minimally invasive nature, there are a number of specific physiological alterations occurring as a result of creating the pneumoperitoneum and the postural changes involved in optimizing patient position. These may be particularly in patients with pre-existing respiratory and cardiovascular disease. In addition, there may be surgical hazards related to trocar insertion or other instrumental injuries leading to haemorrhage, peritonitis or gas embolism. It is important for all clinicians involved with these cases to be familiar with the physiological alterations and potential hazards and for the anaesthetist to employ appropriate techniques and monitoring to allow early detection of problems and to minimize perioperative morbidity.