A mill-wheel type of murmur during laparoscopy suggests
The 'water-wheel' or 'mill-wheel' murmur is classically associated with large intracardiac air emboli and described as a "characteristic splashing auscultatory sound due to the presence of gas in the cardiac chambers." . Most venous air (gas) emboli are iatrogenic . Ref Davidson edition23rd pg 620
Tension pneumothorax
intra-abdominal bleeding
Gas embolism
pre-existing valvular disease
Respiratory system