Anaesthesia and minimally invasive surgery

As with so many different forms of anaesthesia, anaesthesia for minimally invasive surgery is dependent on the type of surgery being performed and the impact of the surgical procedure itself on the human body. With an increase in the number of surgical specialties embracing laparoscopic procedures, anaesthetists must consider the risks and benefits to the patient. On the whole, laparoscopic procedures are well tolerated. The advantages of laparoscopic surgery compared with open procedures are associated with reduced morbidity and mortality. The reductions in acute pain and postoperative respiratory tract infections and ileus allow earlier mobilization and lead to earlier discharge. Laparoscopy also improves the cosmetic appearance. It improves the view of the operative field and enables alternative anatomical views to be seen. Anaesthesia per se is fairly standard in minimally invasive surgery, but it is the comprehension of the effects of the position of the patient and that of the pneumoperitoneum that can make the difference between a successful or less elegant outcome.