The development of “minimally invasive surgery” or “minimal access surgery” has revolutionized the field of surgery (Joshi GP, Cunningham A. Anesthesia for laparoscopic and robotic surgeries. In: Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Ortega R, Stock MC, eds.Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins; 2013:1257–1273). The growth of laparoscopic surgical procedures is attributable to the use of smaller incisions that reduce surgical stress and postoperative pain and reduce overall morbidity, thus resulting in rapid recovery, earlier ambulation, shorter hospital stays, and a rapid return to daily living activities (Table 43-1: Advantages of Minimally Invasive Surgery). Robotic surgery improves depth perception through high-definition, magnified, and three-dimensional view of the operative field and is expected to broaden the application of the minimally invasive surgical paradigm. Despite the potential advantages of laparoscopic and robotic surgery, they are associated with significant physiologic changes as well as new complications (some potentially life threatening) that are usually not seen with the traditional “open” approach (Table 43-2: Potential Complications During Laparoscopy). In addition, robotic procedures can have significantly prolonged operative times and require patients to be placed in extreme positions. In addition, because the robotic system is large, it limits the access to the patient and invades the anesthesia working space.