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JOURNAL/mgres/04.03/01612956-990000000-00083/figure1/v/2026-03-26T165947Z/r/image-tiff As laparoscopic technology evolves rapidly, the safe management and precise detection of carbon dioxide (CO2) pneumoperitoneum have become the core link to ensure surgical safety. Herein, we attempt to systematically explore the research hotspots and innovative technologies in CO2 pneumoperitoneum detection through bibliometric analysis, patent mining and clinical trial data integration. A visual analysis was performed on relevant 80 articles retrieved from the Web of Science Core Collection. (1) Keyword analysis revealed that current research focuses on laparoscopic cholecystectomy, with major complications including postoperative pain, adhesion formation, and gas embolism. (2) Literature co-citation analysis showed that gas pretreatment technology significantly reduces hypothermia and postoperative pain. Relevant international guidelines emphasize the necessity of dynamic end-tidal carbon dioxide monitoring, while the mechanisms linking pneumoperitoneal pressure to cardiovascular and respiratory systems remain the focus of pathophysiological research. (3) Recent studies over the past 5 years have indicated that pneumoperitoneum pressure optimization has emerged as a central research focus. High-pressure pneumoperitoneum significantly increases intracranial pressure, and different surgical approaches variably impact acid-base balance. However, the effects of heated and humidified insufflation gas on postoperative inflammatory responses require further validation. (4) Patent analysis revealed that China's patent- authorized technologies in this field are mainly pneumoperitoneum pressure constant control, gas temperature and humidity regulation, and intelligent monitoring equipment, among which the multi-channel constant-pressure insufflator and integrated humidification pipeline system have become the highlights of innovative technologies. (5) Clinical trial registration protocol analysis revealed that current cutting-edge clinical research focuses on three key areas in robotic surgery: ultra-low pressure pneumoperitoneum management, exploration of novel gas mixture ratios, and intelligent monitoring technologies. (6) The complications of CO2 pneumoperitoneum involve multi-system interactions: cardiovascular compression can affect hemodynamic stability, the respiratory system is vulnerable to the threat of hypercapnia, and prolonged duration of pneumoperitoneum may induce gastrointestinal dysmotility. (7) In terms of technological innovations, CO2 laparoscopic insufflator, intelligent monitoring tools (e.g., ultrasound assessment of intracranial pressure) and anesthesia management protocols (e.g., pharmacological suppression of hemodynamic fluctuations) have gradually shown their clinical potential, but the clinical benefits of gas temperature and humidity control remain controversial. To conclude, this paper reveals the current research status, hotspots and trends in the field of CO2 laparoscopic pneumoperitoneum detection, which provides a reference for the development of precision and safety in laparoscopic surgery.