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Recent evidence demonstrated that carbon dioxide pneumoperitoneum might be modulated in terms of pressure, duration, temperature, and humidity to mitigate and modulate these changes. The aim of this study is to review the current knowledge about animal and human models investigating pneumoperitoneum-related biological and histological impairment. In particular, pneumoperitoneum is associated with local and systemic inflammation, acidosis, oxidative stress, mesothelium lining abnormalities, and adhesion development. Animal studies reported that an increase in pressure and time and a decrease in humidity and temperature might enhance the rate of comorbidities. However, to date, few studies were conducted on humans; therefore, this research field should be further investigated to confirm in experimental models and humans how to improve laparoscopic procedures in the spirit of minimally invasive surgeries.<\/jats:p>","DOI":"10.1155\/2021\/5564745","type":"journal-article","created":{"date-parts":[[2021,5,21]],"date-time":"2021-05-21T15:20:05Z","timestamp":1621610405000},"page":"1-9","source":"Crossref","is-referenced-by-count":24,"title":["The \u201cDark Side\u201d of Pneumoperitoneum and Laparoscopy"],"prefix":"10.1155","volume":"2021","author":[{"given":"Giuseppina Rosaria","family":"Umano","sequence":"first","affiliation":[{"name":"Department of Woman, Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Largo Madonna Delle Grazie N. 1, Naples 8013, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Delehaye","sequence":"additional","affiliation":[{"name":"Department of Woman, Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Largo Madonna Delle Grazie N. 1, Naples 8013, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmine","family":"Noviello","sequence":"additional","affiliation":[{"name":"Department of Woman, Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Largo Madonna Delle Grazie N. 1, Naples 8013, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3846-7872","authenticated-orcid":true,"given":"Alfonso","family":"Papparella","sequence":"additional","affiliation":[{"name":"Department of Woman, Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Largo Madonna Delle Grazie N. 1, Naples 8013, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1007\/s13304-021-01031-5"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cireng.2021.01.003"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-020-07881-1"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1111\/jog.14156"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.4293\/108680811x13071180407276"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.4293\/jsls.2018.00080"},{"key":"7","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1152\/japplphysiol.00814.2020","article-title":"Modeling intra-abdominal volume and respiratory driving pressure during pneumoperitoneum insufflation-a patient-level data meta-analysis","volume":"130","author":"G. 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