Understanding the effects of laparoscopy on hemodynamics and mitigating complications: An anesthetic approach for gynecological surgery

Laparoscopic surgeries have become popular and are now widely used in gynecological procedures due to their minimally invasive nature.  CO2 is used to create the pneumoperitoneum to facilitate the laparoscopic surgery.  Pneumoperitoneum and different positions used can have adverse effects on hemodynamics. Most of the system of the human body are affected including Cardiovascular and pulmonary system leading to various complications. Complications include vascular and bowel injury during pneumoperitoneum access, subcutaneous emphysema, pneumothorax, pneumomediastinum, CO2 embolism and others. Understanding the underlying hemodynamic changes is crucial to tailor the patient's individual needs. Anesthesiologists play a critical role in managing these challenges by closely and vigilantly monitoring hemodynamics, utilizing appropriate anesthetic techniques, and promptly identifying and addressing potential complications.  This paper aims to provide a comprehensive review of the effects of laparoscopy on hemodynamics, expected complications, its management and the current anesthetic approaches used to mitigate these effects in laparoscopic gynecological surgery including postoperative pain management.