[Pathophysiology of capnoperitoneum. Implications for ventilation and hemodynamics]

Laparoscopic surgery was introduced into clinical practice in the early 1950s by gynaecologists. Technical improvements allowed its use for more complex and longer lasting procedures. Reduction of postoperative pain, more favourable cosmetic results, quicker recovery and reduced length of hospital stay proved to be advantageous when compared to open surgery. As a result progressively older patients with corresponding pulmonary and cardiovascular comorbidities and morbidly obese patients are now undergoing advanced laparoscopic surgery. Detailed knowledge of the respiratory and hemodynamic pathophysiology induced by capnoperitoneum is necessary to administer safe anaesthesia to such patients. This review addresses the most important effects of capnoperitoneum and recent research as well as the possible implications for clinical practice.