Laparoscopy is the process of inspecting the abdominal cavity through an endoscope. Initially, gynecologists used these instruments to diagnose pelvic pain. Holding the rigid telescope in one hand and looking through it with the naked eye, it was possible to manipulate a second instrument in the abdominal cavity to move abdominal structures, aspirate cysts, and apply clips to the Fallopian tubes for sterilization. The options for more sophisticated procedures were limited by the need to look directly through the laparoscope. As small video cameras became available in the 1980s, the surgeon was able to use both hands to position surgical instruments, while one or more assistants could contribute to the procedure by sharing the same view as the surgeon. At the same time, specialized instruments were developed to permit suturing, stapling, and other techniques through small access ports (typically 10–15 mm). The range of potential laparoscopic or laparoscopically assisted procedures then expanded enormously. The following is a selection of laparoscopic and laparoscopically assisted procedures. Not all are suitable on an outpatient basis, and the list is not comprehensive.

Laparoscopic surgery is one of the most obvious forms of minimally invasive surgery. There is no doubt that such an approach reduces pain and immobility in the postoperative period because of significantly reduced skin and muscle wounds. Recovery occurs sooner, and hospital stays are reduced. Some procedures (but not all) become possible on an outpatient basis, where previously several days' stay was mandatory. There are disadvantages to laparoscopic surgery as well. Surgical times may be longer (sometimes substantially so), especially during the learning phase. Equipment costs are invariably higher, although these increased direct costs are sometimes compensated by a reduced hospital stay. Laparoscopic surgery can complicate the anesthetic management and introduce new and serious complications that do not exist or are rare with the traditional approach. This article considers the anesthetic techniques for laparoscopic surgery. Emphasis is given to control of postoperative complications (e.g., pain, nausea, vomiting), and several controversies are considered.