الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The evolution of minimally invasive surgery has transformed surgical procedures and, in the process has affected the practice of anaesthesiology. After the establishment of laparoscopy as a minimally invasive surgical diagnostic and therapeutic procedure, anaesthetic techniques have evolved to overcome the complications which appeared with this relatively new technique.
Laparoscopic cholecystectomy has quickly developed as a major substitute to open cholecystectomy for the treatment of gall bladder disease. It almost became the standard technique for the surgical treatment for patients with gallstone disease. It has many advantages like decreased hospital admission, smaller scars and incisions, less postoperative pain and decreased incidence of postoperative ileus compared to open cholecystectomy.
So accordingly, ideal anaesthetic techniques should adapt to the new laparoscopic techniques to ensure perfect intraoperative conditions and provide the postoperative advantages including rapid recovery and decreased occurrence of disadvantages of the procedure. Although general, local and regional anaesthesia could be used successfully for laparoscopy, but the best choice for abdominal laparoscopy is general anaesthesia. It is recommended as it overcome the patient discomfort due to the gas insufflation of the abdomen and the position changes needed during laparoscopy. Controlled ventilation is preferred to overcome the hypercarbia and the impairment of ventilation by the pneumoperitoneum and the extreme positions.
Endotracheal intubation is considered the gold standard in airway management, it made administration and maintenance of anaesthesia possible. However, direct laryngoscopy and endotracheal intubation have their disadvantages such as injury to soft tissues, teeth, vocal cords, and the trachea. It also affects the patient’s haemodynamics and could cause barotrauma.
Supraglottic airway devices ventilate patients by transferring oxygen and anaesthetic gases above the level of the vocal cords, so they overcome the complications caused by endotracheal intubation. They have advantages of being less invasive causing less airway irritation and less haemodynamic changes, easier administration by less experienced staff, and decreased occurrence of sore throat and airway injury.