Advances in surgical laparoscopic techniques have greatly reduced surgical trauma, significantly shortened the number of hospital days, and reduced hospital costs. Compared to open surgery, laparoscopy offers several advantages and has the characteristic of better maintenance of a stable internal environment. Since Phillipe Mouret reported the first laparoscopic cholecystectomy (LPC) in 1987, it has been widely performed in the surgical fields of gastrointestinal surgery, hepatobiliary surgery, urology, and gynecology due to the advantages of less trauma, safety, simplicity, shorter postoperative recovery period, shorter hospital stay, and reduced postoperative pain time. However, artificial pneumoperitoneum may also lead to serious complications such as bubble pulmonary embolism, and even lead to the death of the patient. Generally speaking, bubble pulmonary embolism is divided into two major categories: 1. Giant bubble pulmonary embolism (1) Symptoms: similar to general pulmonary thrombosis and embolism, the onset of acute decrease in whistling CO2, another drop in blood pressure, arrhythmia, hypoxemia, hypercarbia, abnormal heart sounds, electrocardiogram changes and other symptoms, sometimes may be complicated by cardiac arrest, leading to the death of the patient or complicated by post-resuscitation syndrome, ischemic-hypoxic encephalopathy. (2) Disposition: immediately change to a surgical position where gas does not enter the vein, and immediately stop gas delivery, release the pneumoperitoneum, and change to a position with rising venous pressure in the operative field. Use vaso-excitatory drugs and catecholamines when blood pressure decreases, and inhale high concentrations of oxygen when hypoxemia is present. (3) Prognosis Because the CO2 obstructing the blood vessel is easily dissolved in the blood, it is characterized by the rapid disappearance and recovery seen clinically through treatment. Although there are reports of fatalities, the prognosis is also good if the risk period of dissolving huge bubbles in blood can be passed after the onset. 2. Microbubble pulmonary embolism (1) Symptoms: It has been reported that the end-of-whistle partial pressure of CO2 (PetCO2) rises abruptly at the beginning and then starts to decrease slowly for about 30 seconds. Continuous monitoring of PetCO2 is important. It has been confirmed by pulmonary flow scintigraphy studies that PetCO2 is increased in the pneumoperitoneum in the group of patients with micro pulmonary embolism compared to the group of patients without embolism. It is believed that there is no change in pulmonary embolism or circulatory status, if any, due to these tiny air bubbles is relatively mild. (2) Disposition: In the case of air embolism, especially that caused by CO2 bubbles, the oxygen content of the inhaled air should be changed to reduce the partial pressure of the bubble components and shorten the time of bubble dissolution in the blood while ensuring adequate ventilation. With the prolongation of pneumoperitoneum, the risk of pulmonary embolism increases, so it is important to shorten the duration of pneumoperitoneum as much as possible. (3) Prognosis: At the end of surgery, mild hypercapnia and hypoxemia are seen, and the occurrence of circulatory failure is extremely rare. A postoperative pulmonary flow scintigraphy study reported that a diffuse defect image of the whole lung field could remain at 25 days postoperatively, but the defect image disappeared at 12 weeks. Therefore, it is believed that CO2-induced pulmonary embolism can disappear early with the passage of time, and complete disappearance takes 12 weeks.