Pathophysiologic effects of prolonged laparoscopic operation.

Laparoscopy may have significant effects on homeostasis, particularly on the cardiovascular and pulmonary systems. The surgeon needs to appreciate the complex interactions of increased intra-abdominal pressure, changes in patient position, and gas absorption in order to appropriately select patients for laparoscopic procedures. Practical guidelines for the avoidance and management of complications due to pathophysiologic derangement during laparoscopy are included.