As a chief resident in genreal surgery, I have seen many approaches to laprascopic cholecystectomy, and among the seven hospitals where I rotate, a wide variation in the incidence of postoperative nausea. And I have come to the conclusion that the anesthetic has much more to do with the incidence of postop nausea than anything the surgeon does.
I recently completed a rotation at a children's hospital, and this hospital had begun performing palrascopic surgery only 20 months prior. The anesthesiologists prefer a gas induction, with palcement of IVs, foleys, and lines under gnereal anesthesia. We had a terrible postop nausea problem after lap chole, causing some patients to stay 3-4 days! I suggested to one anesthesiologist that we try IV induction on our adolescent patients who were undergoing laprascopic surgery, and he chose propofol and versed, with non-depolarizing paralytics. Not an ounce of vomitus has hit the floor since in these patients.
Nausea is more severe in all patients in whom volatile anesthetics are not allowed to diffuse off prior to reawakening; I believe some of the volatile agents end up in the pneumoperitoneum, and are then reabsorbed by the patient, even as they are awakened.