[Anesthesiologic aspects of minimally invasive surgery--preoperative assessment]

Laparoscopic surgery may be associated with increased perioperative morbidity due to respiratory and cardiocirculatory problems. Preoperative assessment requires a diagnostic program including laboratory tests and noninvasive diagnostic studies, and a physical status classification. High-risk patients are those with intracardial right-to-left shunts (increased risk of gas embolism) and patients in shock. Increased intraoperative morbidity is expected in patients with manifest cardiac failure or severely restricted pulmonary function. In patients with moderate pulmonary dysfunction laparoscopic procedures seem to be associated with the benefit of a better postoperative pulmonary function.