Laparascopic surgery required inducing a pneumoperitoneum during surgery and anesthesia this presents unique hemodynamic challenges for the anesthetic management of patients. We monitored hemodynamic management using ECOM endotracheal tubes the parameters are derived using Bioimpedance Cardiac output, stroke volume variability, and systemic vascular resistance were measured using this technology. Pneumoperitoneum results in intra-abdominal pressure of 15–20 mm hg induced by $CO2$ insufflation Hemodynamic parameters were measured using a new noninvasive device, the endotracheal cardiac output monitor (ECOM) (ConMed Corporation, Utica, NY). This monitor provides measurements—including cardiac output, systemic vascular resistance, and stroke volume variation—which were previously unavailable noninvasively. The results obtained were consistent with those found in the literature (1–4). Based on our assessment, it appears that ECOM derived hemodynamic changes are similar to those obtained invasively. Therefore, ECOM’s noninvasive method to measure cardiac output seems advantageous when considering patient safety, because it is less invasive. A better understanding of the applicability and reliability of this new technology in the clinical setting is important for patient safety.