This document discusses the cardiovascular, respiratory, renal, hepatic, and other physiologic effects of pneumoperitoneum during laparoscopic surgery. Pneumoperitoneum, or insufflation of carbon dioxide gas into the abdominal cavity, can cause hemodynamic changes such as decreased venous return and cardiac output. It can also decrease lung volumes and impair respiratory function. These effects are more pronounced in elderly or debilitated patients undergoing laparoscopic surgery. The document emphasizes the importance of intraoperative monitoring and management strategies to optimize patient hemodynamics and ventilation during pneumoperitoneum, especially in high-risk patients.