1. Minimally invasive surgery reduces postoperative pain and ileus, facilitates recovery, allows shorter hospital stays, and allows a rapid return to activities of daily living.
2. Robotic surgery offers technical advantages over laparoscopic surgery and thus should further expand the field of minimally invasive surgery.
3. The physiologic changes associated with pneumoperitoneum creation and patient positioning may cause significant cardiorespiratory compromise, particularly in patients with significant cardiopulmonary dysfunction.
4. Balanced general anesthesia technique with mechanical ventilation remains the best practice for minimally invasive surgical procedures requiring CO₂ insufflation.
5. Aggressive multimodal analgesic as well as antiemetic prophylaxis and treatment are required to reduce postoperative adverse effects.
6. If intraoperative cardiopulmonary impairment occurs, it is important to confirm that the IAP is <15 mm Hg and to rule out traumatic vascular injuries, CO₂ embolism, subcutaneous emphysema, capnothorax, and capnomediastinum.
   1. If there is no improvement in the vital signs with routine management, it is imperative to release the pneumoperitoneum and place in the patient in a supine (or Trendelenburg) position.
   2. After cardiopulmonary stabilization, cautious slow reinsufflation may then be attempted.
   3. With persistent signs of significant cardiopulmonary impairment, it may be necessary to convert to an open procedure.

Anesthesia for Laparoscopic and Robotic Surgeries

1. Surgical Techniques
2. Physiologic Effects
3. Anesthetic Management
4. Pain Prevention
5. Intraoperative Complications
6. Postoperative Considerations
7. Ambulatory Laparoscopic Procedures
8. Summary