The gained experience of laparoscopic surgery technique upraised the questions about the features of this type of surgery. In particular, the problem of laparoscopic surgery influence on the peritoneum. There is a close relationship between the local mesotheliocytes response to the trauma — dysfunction of the endothelium and dysfunction of the mesothelium. This relationship is in detail described in the modern theory of epithelial-endothelial dysfunction, which is common for both of the mentioned above processes in the epithelium and endothelium in all organs. What is the systemic peritoneal response while laparoscopy? Are these changes reversible? Is it possible to prevent or, at least, reduce technogenic laparoscopic peritoneal remodeling? Experimental studies have shown that the degree of peritoneal dysfunction depends on the level of the gas pressure and the duration of the intervention (i.e. the «intensity» and duration of the pneumoperitoneum). We should take into consideration another question of laparoscopy effect on the peritoneum within peritonitis. More and more laparoscopic interventions are being performed for the treatment of different etiology peritonitis. Laparoscopic interventions should be considered not only as highly effective surgical technologies, but also as an object for further fundamental scientific experimental and clinical studies.