The introduction of laparoscopy and minimally invasive surgery for the diseases of the gastrointestinal tract resulted in a major change in the operating room setting and surgeons’ working environment. Laparoscopy comes with dedicated complex technologies that need to be perfectly understood since it can be responsible of unique complications associated with this approach. Complications of laparoscopic surgery can be grouped into the following three categories: complication of access, physiologic complications of the pneumoperitoneum, and complications of the operative procedure. The creation of the working space by gas insufflation in the peritoneal or extraperitoneal space is unique to laparoscopy and can cause significant complications such as vascular injuries and injuries to other intra-abdominal viscus. Injuries can also result from inappropriate manipulation of laparoscopic instruments. The creation of pneumoperitoneum can cause several local and systemic effects which may be detrimental. Therefore, performing a « simple » task and « simple » surgical maneuvers can be quite complex in a new working environment.

The topic will be covered in two lectures where we review the basic techniques of laparoscopy, and the main principles of laparoscopic surgery. The first lecture focuses on OR setup, patient installation, type of gas used to create the laparoscopic working space, method of creation of pneumoperitoneum. The second lecture will focus on type of trocars, together with the description of exposure, dissection, sutures and anastomosis techniques. The knowledge of these basic principles is mandatory from anybody willing to learn how to perform laparoscopy.