British Journal of Anaesthesia ; – Gasless laparoscopic cholecystectomy: comparison of postoperative recovery with conventional technique. This interesting treatise begins with a well-done historical review of laparoscopy. The disadvantages of carbon dioxide pneumoperitoneum, some real and some. PDF | On Dec 1, , L Angelini and others published Gasless laparoscopy.
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Two techniques were used: Gasless laparoscopic technique of wide excizion for gastric gastrointestinal stromal tumor versus open method.
With both techniques used, sample of the intraperitoneal fluid or biopsy could be obtained. An interesting study by Koivusalo et alshowed that gasless versus classical laparoscopy offers advantages in terms of postoperative recovery: Pneumoperitoneum, as a necessary precondition of laparoscopic procedures, represents a restriction of the surgeon’s freedom of movement and can lead to rare but typical complications.
Gasless laparoscopy in abdominal surgery.
Laparoscopy, gasless laparoscopy, emergency, contraindications. Also a study of Ge et al, in cases of appendectomies performed by gasless laparoscopy showed significantly decreased hospital costs 8. In these patients, diagnostic gasless laparoscopy that identifies hemoperitoneum lapaorscopy be followed by laparotomy. For these 49 procedures, two methods were used: In cholecystectomy and bowel resection the advantages of being able to use traditional instruments are stressed.
All cases with incision infections were managed by antibiotics and local treatment, while the hematoma was managed by drainage.
The role of gasless laparoscopy in differential diagnosis of acute abdomen
Final diagnoses were established in 41 patients and are presented in detail in Figure 1while in eight patients no obvious cause was identified or existed. Of these eight cases without diagnosis, five involved multiple trauma with symptoms of acute abdomen, in which we could not identify any pathological findings by gasless laparoscopy. Specific to the laparolift system, increased post-operative gaslesz of the anterior abdominal wall was observed, caused by the mechanical lift.
Gasless Laparoscopy With Conventional Instruments: Also, in our study two intraoperative complications occurred, that involved bleeding after hepatic biopsy with the LapVision system.
Tec- niche diagnostiche ed operative. Gaslless authors’ analysis of gasless laparoscopy is informative and gives the reader a historical perspective of this evolving technique.
Gasless Laparoscopy With Conventional Instruments: The Next Phase in Minimally Invasive Surgery
Table 1 Indications for gasless laparoscopy and number of cases for each indication. The gasless technique for laparoscopy is an extremely useful mean of diagnosis in emergency conditions, or for patients with contraindications to undergo laparoscopy by pneumoperitoneum. In addition, the simplicity of the method makes it economically feasible.
Author information Copyright and License information Disclaimer. Conclusions Gasless laparoscopy is a useful method for the differential diagnosis of acute abdomen causes in cases of extreme graveness and urgency.
Low-pressure pneumoperitoneum laparoscopic surgery. Also, both allow the use of any ordinary tools for aspiration and drainage, making the technique cheap and easy to implement. First of all, the view is somewhat inadequate, especially in the lateral laparosdopy inferior quadrants.
It is though under consideration, once our experience is advanced, to use this method for therapeutic applications laparsocopy the future. Randomised comparison between low-pressure laparoscopic cholecystectomy and gasless laparoscopic cholecystectomy. The midportion of the text is devoted to the application of the techniques to three areas of general surgery, the biliary tract, herniorrhaphy, and bowel resection.
The retractor system used is described in detail and involves an intraabdominal device attached to a hydraulic lifting apparatus. Especially in six cases treated this way, the postoperative pain was very intense and high doses of painkillers were required.
Gasless laparoscopy in abdominal surgery.
Compared to the traditional procedure with a CO2 pneumoperitoneum, the results of the first gasless procedures demonstrate potential advantages. Table 2 Treatment based on diagnosis made by gasless diagnostic laparoscopy. National Center for Biotechnology InformationLapaeoscopy.