Most of endoscopic surgeries are performed under local or regional anesthesia depending on the patients’ comorbidities and personal choices. An efficient sedation covering anxiolysis, analgesia and amnesia provides a good comfort for both the surgeon and the patient undergoing endourological interventions with local/regional anesthesia. Laparoscopic and robotic-assisted surgeries are now widely used due to being more precise and still being minimal invasive techniques. They require special anesthetic considerations taking the physiological changes into account due to pneumoperitoneum and surgical position. Pneumoperitoneum causes low FRC, reduced compliance, ventilation-perfusion mismatch, and even pulmonary edema. Prolonged steep trendelenburg results in cephalad shift of diaphragma which occassionally leads intubation tube displacement. In addition, edema in the upper airways and face, cerebral and intraocular pressure elevation may be present. Both pneumoperitoneum and prolonged trendelenburg position complicate intraoperative fluid management from anesthesiologic aspect. Implementation of personalized fluid protocols will be beneficial in preventing postoperative complications. Zero balance fluid regimen seems to be the most convenient approach to prevent such complications. Laparoscopic and robotic surgeries reduce postoperative pain and analgesic requirement compared to open technics. Multimodal analgesia including IV parasetamol, patient-controlled analgesia (PCA) and ultrasound guided thoracic wall (paravertebral, erector spinae plane) or abdominal wall (transversus abdominis plane, rectus sheet, quadratus lumborum) blocks can be preferred.