ABSTRACT
Many surgical procedures dictate the management of anesthesia. The procedure of laparoscopy creates its own subset of factors unique to the procedure itself. The impact of laparoscopy on the human body went relatively unnoticed in its infancy because the majority of cases initially were laparoscopic tubal sterilizations performed in a relatively short time on young, healthy individuals. Barring complications, these individuals could adjust quite well to the changes that occur during laparoscopy. Only when the technique expanded, both in use and type of operations, was the full impact apparent. Presently, laparoscopic operations are frequently longer, and the population may have other disease processes, and may even be elderly. This subset of patients has not been able to compensate as well as young, healthy patients, and the true impact of these physiologic changes is being delineated. This expansion has been a useful and productive development, but as shown later in this chapter, the choice of laparoscopy versus an open procedure is made by the physiologic impact of the laparoscopy on the individual patient during the operative procedure and not only on the physical factor of surgery without a major incision.
