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The Evolution of Minimally Invasive Gynecological Surgery: Gas-Less Laparoscopic Inspection and Single Hole Surgery (GLISHS)

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Laparoscopic Entry

Abstract

In the last two decades, laparoscopy has become the standard treatment for many gynecological conditions. However, one major obstacle to the more widespread application of endoscopic procedures has been the limitations encountered with conventional laparoscopy. These include poor surgeon ergonomics, counterintuitive hand movement owing to undesirable long instruments, limited degrees of instrument motion within the body, and maintenance of CO2 pneumoperitoneum. Another major obstacle has been the rising cost of laparoscopic surgery, which always employs new and expensive tools to improve the safety and execution of operations.

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References

  1. Barnett RB, Gordon S, Drizin GS. Pulmonary changes after laparoscopic cholecystectomy. Surg Laparosc Endosc. 1992;2:125–7.

    Article  PubMed  CAS  Google Scholar 

  2. Beebe DS, McNevin MP, Crain JM, Letourneau JC, Belani KG, Abrahms JA, et al. Evidence of venous stasis after abdominal insufflation for laparoscopic cholecystectomy. Surgery. 1993;176:443–7.

    CAS  Google Scholar 

  3. Brown DR, Fishburne JI, Roberson VO, Hulka JF. Ventilatory and blood gas changes during laparoscopy with local anesthesia. Am J Obstet Gynecol. 1976;124:741–5.

    PubMed  CAS  Google Scholar 

  4. Fitzgerald SD, Andrus CH, Baudendistel LJ, Dahms TE, Kaminski DL. Hypercarbia during carbon dioxide pneumoperitoneum. Am J Surg. 1992;163:186–90.

    Article  PubMed  CAS  Google Scholar 

  5. Ho HS, Gunther RA, Wolfe BN. Intraperitoneal carbon dioxide insufflation and cardiopulmonary function. Arch Surg. 1992;127:928–33.

    Article  PubMed  CAS  Google Scholar 

  6. Ivankovic AD, Miletich DJ, Albrecht RF, Heyman HJ, Bonnet RF. Cardiovascular effects of intraperitoneal insufflation with carbon dioxide and nitrous oxide in the dog. Anesthesiology. 1975;42:281–7.

    Article  Google Scholar 

  7. Khan RM, Maroof M, Bhatti TH, Hamalawy H, Abbas JS. Correlation of end tidal CO2 and haemodynamic variation following CO2 insufflation during laparoscopic cholecystectomy. Anesthesiology. 1992;77:464–7.

    Article  Google Scholar 

  8. Lenz RJ, Thomas TA, Wilkins DG. Cardiovascular changes during laparoscopy. Anaesthesia. 1976;31:4–12.

    Article  PubMed  CAS  Google Scholar 

  9. Volz J, Koster S, Weis M, Schmidt R, Urbaschek R, Melchert T, et al. Pathophysiologic features of a pneumoperitoneum at laparoscopy: a swine model. Am J Obstet Gynecol. 1996;174:132–40.

    Article  PubMed  CAS  Google Scholar 

  10. Kelman GR, Swapp GH, Benzie RJ, Gordon NLM. Cardiac output and arterial blood gas tension during laparoscopy. Br J Anaesth. 1972;44:1155–62.

    Article  PubMed  CAS  Google Scholar 

  11. Motew M, Ivankovic A, Bieniarz J, Albrecht RF, Zahed B, Scommegna A. Cardiovascular effects and acid-base and blood gas changes during laparoscopy. Am J Obstet Gynecol. 1973;115:1002–12.

    PubMed  CAS  Google Scholar 

  12. Seed RF, Shakespeare TF, Muldoon MJ. Carbon dioxide homeostasis during anaesthesia for laparoscopy. Anaesthesia. 1970;25:223–31.

    Article  PubMed  CAS  Google Scholar 

  13. Neuhaus SJ, Watson DI, Ellis T, Rofe AM, Mathew G, Jamieson GG. Influence of gases on intraperitoneal immunity during laparoscopy in tumor-bearing rats. World J Surg. 2000;24:1227–31.

    Article  PubMed  CAS  Google Scholar 

  14. Trokel MJ, Bessler M, Treat MR, Whelan RL, Nowygrod R. Preservation of immune response after laparoscopy. Surg Endosc. 1994;8:1385–8.

    Article  PubMed  CAS  Google Scholar 

  15. Watson RWG, Redmond HP, McCarthy J. Exposure of the peritoneal cavity to air regulates early inflammatory responses to surgery in a murine model. Br J Surg. 1995;82:1060–5.

    Article  PubMed  CAS  Google Scholar 

  16. Akira S, Yamanaka A, Ishihara T, Takeshita T, Araki T. Gasless laparoscopic ovarian cystectomy during pregnancy: comparison with laparotomy. Am J Obstet Gynecol. 1999;180:554–7.

    Article  PubMed  CAS  Google Scholar 

  17. Amos JD, Schorr SJ, Norman PF, Poole GV, Thomae KR, Mancino AT, et al. Laparoscopic surgery during pregnancy. Am J Surg. 1996;171:435–7.

    Article  PubMed  CAS  Google Scholar 

  18. Cruz AM, Southerland LC, Duke T, Townsend HG, Ferguson JG, Crone LA. Intraabdominal carbon dioxide insufflation in the pregnant ewe. Uterine blood flow, intraamniotic pressure, and cardiopulmonary effects. Anesthesiology. 1996;85:1395–402.

    Article  PubMed  CAS  Google Scholar 

  19. Hess LW, Peaceman A, O’Brien WF, Winkel CA, Cruikshank DP, Morrison JC. Adnexal mass occurring with intrauterine pregnancy: report of fifty-four patients requiring laparotomy for definitive management. Am J Obstet Gynecol. 1988;158:1029–34.

    PubMed  CAS  Google Scholar 

  20. Hunter JG, Swanstorm L, Thomburg K. Carbon dioxide pneumoperitoneum induces fetal acidosis in a pregnant ewe model. Surg Endosc. 1995;9:272–9.

    PubMed  CAS  Google Scholar 

  21. Carroll BJ, Chandra M, Phillips EH, Harold JG. Laparoscopic cholecystectomy in the heart transplant candidate with acute cholecystitis. J Heart Lung Transplant. 1992;11:831–3.

    PubMed  CAS  Google Scholar 

  22. Chamberlain G, Brown JC. Gynaecological laparoscopy: report on the confidential inquiry into gynaecological laparoscopy. London: Royal College of Obstetricians and Gynaecologists; 1978.

    Google Scholar 

  23. De Sousa H, Tyler IL. Can absorption of the insufflation gas during laparoscopy be hazardous? Anesthesiology. 1987;67:476–80.

    Article  Google Scholar 

  24. Holzman M, Sharp K, Richards W. Hypercarbia during CO2 gas insufflation for therapeutic laparoscopy: a note of caution. Surg Laparosc Endosc. 1992;2:11–4.

    PubMed  CAS  Google Scholar 

  25. Johannsen G, Juhl B. The effect of general anaesthesia on the haemodynamic events during laparoscopy with CO2 insufflation. Acta Anaesthesiol Scand. 1989;33:132–6.

    Article  PubMed  CAS  Google Scholar 

  26. Kent RB. Subcutaneous emphysema and hypercarbia following laparoscopic cholecystectomy. Arch Surg. 1991;126:1154–6.

    Article  PubMed  Google Scholar 

  27. Taura P, Lopez A, Lacy AM, Anglada T, Beltran J, Fernandez-Cruz L, et al. Prolonged pneumoperitoneum at 15 mm Hg causes lactic acidosis. Surg Endosc. 1998;12:198–201.

    Article  PubMed  CAS  Google Scholar 

  28. Ott DE. Contamination via gynaecologic endoscopy insufflation. J Gynecol Surg. 1989;5:205–85.

    Article  Google Scholar 

  29. Canis M, Botchorishvili R, Wattiez A, Mage G, Pouly JL, Bruhat MA. Tumor growth and dissemination after laparotomy and CO2 pneumoperitoneum: a rat ovarian cancer model. Obstet Gynecol. 1998;92:104–8.

    Article  PubMed  CAS  Google Scholar 

  30. Canis M, Botchorishvili R, Wattiez A, Pouly JL, Mage G, Manhes H, et al. Cancer and laparoscopy, experimental studies: a review. Eur J Obstet Gynecol Reprod Biol. 2000;91:1–9.

    Article  PubMed  CAS  Google Scholar 

  31. Dorrance HR, Oien K, O’Dwyer PJ. Effects of laparoscopy on intraperitoneal tumor growth and distant metastases in an animal model. Surgery. 1999;126:35–40.

    Article  PubMed  CAS  Google Scholar 

  32. Gutt CN, Kim ZG, Schmandra T, Paolucci V, Lorenz M. Carbon dioxide pneumoperitoneum is associated with increased liver metastases in a rat model. Surgery. 2000;127:566–70.

    Article  PubMed  CAS  Google Scholar 

  33. Hopkins MP, Dulai RM, Occhino A, Holda S. The effects of carbon dioxide pneumoperitoneum on seeding of tumor in port sites in a rat model. Am J Obstet Gynecol. 1999;181:1329–34.

    Article  PubMed  CAS  Google Scholar 

  34. Hopkins MP, von Gruenigen V, Haller NA, Holda S. The effect of various insufflation gases on tumor implantation in an animal model. Am J Obstet Gynecol. 2002;187:994–6.

    Article  PubMed  Google Scholar 

  35. Jacobi CA, Sabat R, Bohm B, Zieren HU, Volk HD, Muller JM. Pneumoperitoneum with carbon dioxide stimulates growth of malignant colonic cells. Surgery. 1997;121:72–8.

    Article  PubMed  CAS  Google Scholar 

  36. Jones DB, Guo LW, Reinhard MK, Soper NJ, Philpott GW, Connett J. Impact of pneumoperitoneum on trocar site implantation of colon cancer in hamster model. Dis Colon Rectum. 1995;38:1182–8.

    Article  PubMed  CAS  Google Scholar 

  37. Smidt VJ, Singh DM, Hurteau JA, Hurd WW. Effect of carbon dioxide on human ovarian carcinoma cell growth. Am J Obstet Gynecol. 2001;185:1314–7.

    Article  PubMed  CAS  Google Scholar 

  38. Bacha EA, Barber W, Ratchford W. Port-site metastases of adenocarcinoma of the fallopian tube after laparoscopically assisted vaginal hysterectomy and salpingo-oophorectomy. Surg Endosc. 1996;10:1102–3.

    Article  PubMed  CAS  Google Scholar 

  39. Bouvy ND, Marquet RL, Jeekel H, Bonjer J. Impact of gas(less) laparoscopy and laparotomy on peritoneal tumor growth and abdominal wall metastases. Ann Surg. 1996;224(6):694–701.

    Article  PubMed  CAS  Google Scholar 

  40. Cavina E, Goletti O, Molea N, Buccianti P, Chiarugi M, Boni G, et al. Trocar site tumor recurrences. May pneumoperitoneum be responsible? Surg Endosc. 1998;12:1294–6.

    Article  PubMed  CAS  Google Scholar 

  41. Childers JM, Aqua KA, Surwit EA, Hallum AV, Hatch KD. Abdominal-wall tumor implantation after laparoscopy for malignant conditions. Obstet Gynecol. 1994;84:765–9.

    PubMed  CAS  Google Scholar 

  42. Cirocco WC, Schwartzman A, Golub RW. Abdominal wall recurrence after laparoscopic colectomy for colon cancer. Surgery. 1994;116:842–6.

    PubMed  CAS  Google Scholar 

  43. Dobronte Z, Wittmann T, Karacsony G. Rapid development of malignant metastases in the abdominal wall after laparoscopy. Endoscopy. 1978;10:127–30.

    Article  PubMed  CAS  Google Scholar 

  44. Faught W, Fung M. Port site recurrences following laparoscopically managed early stage endometrial cancer. Int J Gynecol Cancer. 1999;9:256–8.

    Article  PubMed  Google Scholar 

  45. Fusco MA, Paluzzi MW. Abdominal wall recurrence after laparoscopic-assisted colectomy for adenocarcinoma of the colon. Dis Colon Rectum. 1993;36:858–61.

    Article  PubMed  CAS  Google Scholar 

  46. Gleeson NC, Nicosia SV, Mark JE, Hofman MS, Cavanagh D. Abdominal wall metastases from ovarian cancer after laparoscopy. Am J Obstet Gynecol. 1993;169:522–3.

    PubMed  CAS  Google Scholar 

  47. Hopkins MP, von Gruenigen V, Gaich S. Laparoscopic port site implantation with ovarian cancer. Am J Obstet Gynecol. 2000;182:735–6.

    Article  PubMed  CAS  Google Scholar 

  48. Jacquet P, Averbach A, Jacquet N. Abdominal wall metastasis and peritoneal carcinomatosis after laparoscopic assisted colectomy for colon cancer. Eur J Surg Oncol. 1995;21:568–70.

    Article  PubMed  CAS  Google Scholar 

  49. Lane G, Tay J. Port site metastasis following laparoscopic lymphadenectomy for adenosquamous carcinoma of the cervix. Gynecol Oncol. 1999;74:130–3.

    Article  PubMed  CAS  Google Scholar 

  50. Lehner R, Wenzl R, Heinzl H, Husslein P, Sevelda P. Influence of delayed staging laparotomy after laparoscopic removal of ovarian masses later found to be malignant. Obstet Gynecol. 1998;92:967–71.

    Article  PubMed  CAS  Google Scholar 

  51. Leminem A, Lehtovirta P. Spread of ovarian cancer after laparoscopic surgery: report of eight cases. Gynecol Oncol. 1999;75:387–90.

    Article  Google Scholar 

  52. Muntz HG, Goff BA, Madsen BL, Yon JL. Port site recurrence after laparoscopic surgery for endometrial carcinoma. Obstet Gynecol. 1999;93:807–9.

    Article  PubMed  CAS  Google Scholar 

  53. Naumann RW, Spencer S. An umbilical metastasis after laparoscopy for squamous cell carcinoma of the cervix. Gynecol Oncol. 1997;64:507–9.

    Article  PubMed  CAS  Google Scholar 

  54. Nduka C, Monson J, Menzies-Gow N, Darzi A. Abdominal wall metastases following laparoscopy. Br J Surg. 1994;81:648–52.

    Article  PubMed  CAS  Google Scholar 

  55. Paolucci V, Schaeff B, Schneider M, Gutt C. Tumor seeding following laparoscopy: international survey. World J Surg. 1999;23:989–95.

    Article  PubMed  CAS  Google Scholar 

  56. Tjalma WA, Winter-Roach BA, Rowlands P, De Barros Lopes A. Port-site recurrence following laparoscopic surgery in cervical cancer. Int J Gynecol Cancer. 2001;11:409–12.

    Article  PubMed  CAS  Google Scholar 

  57. Volz J, Köster S, Schaeff B, Paolucci V. Laparoscopic surgery: the effects of insufflation gas on tumor-induced lethality in nude mice. Am J Obstet Gynecol. 1998;178:793–5.

    Article  PubMed  CAS  Google Scholar 

  58. Wang PH, Yen MS, Yuan CC, Chao KC, Ng HT. Port site metastasis after laparoscopic-assisted vaginal hysterectomy for endometrial cancer: possible mechanisms and prevention. Gynecol Oncol. 1997;66:151–5.

    Article  PubMed  CAS  Google Scholar 

  59. Alexander RJT, Jaques BC, Mitchell KG. Laparoscopically assisted colectomy and wound recurrence. Lancet. 1993;341:250–6.

    Google Scholar 

  60. Mathew G, Watson DI, Ellis TS, Jamieson GG, Rofe AM. The role of peritoneal immunity and the tumour-bearing state on the development of wound and peritoneal metastases after laparoscopy. Aust N Z J Surg. 1999;69:14–8.

    Article  PubMed  CAS  Google Scholar 

  61. Slater NJ, Ratterv AT, Cope GH. The ultrastructure of human abdominal mesothelium. J Anat. 1989;167:47–56.

    PubMed  CAS  Google Scholar 

  62. Wang PH, Yuan CC, Chao KC, Yen MS, Ng HT, Chao HT. Squamous cell carcinoma of the cervix after laparoscopic surgery. J Reprod Med. 1997;42:801–4.

    PubMed  CAS  Google Scholar 

  63. Koivusalo AM, Kellokumpu I, Ristkari S, Lindgren L. Splanchnic and renal deterioration during and after laparoscopic cholecystectomy: a comparison of the carbon dioxide pneumoperitoneum and the abdominal wall lift method. Anesth Analg. 1997;85:886–91.

    PubMed  CAS  Google Scholar 

  64. Koivusalo AM, Kellokumpu I, Scheinin M, Tikkanen I, Makisalo H, Lindgren L. A comparison of gasless mechanical and conventional carbon dioxide pneumoperitoneum methods for laparoscopic cholecystectomy. Anesth Analg. 1998;86:153–8.

    PubMed  CAS  Google Scholar 

  65. Lukban JC, Jaeger J, Hammond KC, LoBraico DA, Gordon AM, Graebe RA. Gasless versus conventional laparoscopy. N J Med. 2000;97:29–34.

    PubMed  CAS  Google Scholar 

  66. Schulze S, Lyng KM, Bugge K, Perner A, Bendtsen A, Thorup J, et al. Cardiovascular and respiratory changes and convalescence in laparoscopic colonic surgery: comparison between carbon dioxide pneumoperitoneum and gasless laparoscopy. Arch Surg. 1999;134:1112–8.

    Article  PubMed  CAS  Google Scholar 

  67. Cravello L, D’Ercole C, Roger V, Samson D, Blanc B. Laparoscopic surgery in gynecology: randomized prospective study comparing pneumoperitoneum and abdominal wall suspension. Eur J Obstet Gynecol Reprod Biol. 1999;83:9–14.

    Article  PubMed  CAS  Google Scholar 

  68. D’Ercole C, Cravello L, Guyon F, DeMontgolfier R, Boubli L, Blanc B. Gasless laparoscopic gynecologic surgery. Eur J Obstet Gynecol Reprod Biol. 1996;66:137–44.

    Article  PubMed  Google Scholar 

  69. Johnson PL, Sibert KS. Laparoscopy: gasless vs CO2 pneumoperitoneum. J Reprod Med. 1997;42:255–9.

    PubMed  CAS  Google Scholar 

  70. Kruczynski D, Scaffer U, Knapstein PG. Gasless laparoscopy with conventional surgical instruments. Gynecol Endosc. 1996;5:277–81.

    Article  Google Scholar 

  71. Smith RS, Fry WR, Tsoi EK, Henderson VJ, Hirvela ER, Koehler RH. Gasless laparoscopy and conventional instruments: the next phase of minimally invasive surgery. Arch Surg. 1993;128:1102–7.

    Article  PubMed  CAS  Google Scholar 

  72. Hill DJ, Maher PJ, Wood HF. Gasless laparoscopy. Aust N Z J Obstet Gynecol. 1994;6:185–92.

    Google Scholar 

  73. Paolucci V, Schaeff B, editors. Gasless laparoscopy in general surgery and gynecology. New York: Thieme; 1996.

    Google Scholar 

  74. Tanaka H, Futamura N, Takubo S, Toyoda N. Gasless laparoscopy under epidural anesthesia for adnexal cysts during pregnancy. J Reprod Med. 1999;44:929–32.

    PubMed  CAS  Google Scholar 

  75. Goldberg JM, Maurer WG. A randomized comparison of gasless laparoscopy and CO2 pneumoperitoneum. Obstet Gynecol. 1997;90:416–20.

    Article  PubMed  CAS  Google Scholar 

  76. Guido RS, Brooks K, McKenzie R, Gruss J, Krohn MA. A randomized, prospective comparison of pain after gasless laparoscopy and traditional laparoscopy. J Am Assoc Gynecol Laparosc. 1998;5:149–53.

    Article  PubMed  CAS  Google Scholar 

  77. Hashimoto D, Nayeem SA, Kajiwara S, Hoshino T. Laparoscopic cholecystectomy: a new approach without pneumoperitoneum. Surg Endosc. 1993;7:54–6.

    Article  PubMed  CAS  Google Scholar 

  78. Nagai H, Kondo Y, Yasuda T. An abdominal wall-lift method of laparoscopic cholecystectomy without peritoneal insufflation. Surg Laparosc Endosc. 1993;3:175–9.

    PubMed  CAS  Google Scholar 

  79. Gasbarro N, Lupo P, Brusati M, Leanza V. Chirurgia ginecologica meno invasiva e riparazione lesioni iatrogene. Ed. Abiabè 2006.

    Google Scholar 

  80. Fader AN, Rojas-Espaillat L, Ibeanu O, Grumbine FC, Escobar PF. Laparoendoscopic single-site surgery (LESS) in gynecology: a multi-institutional evaluation. Am J Obstet Gynecol. 2010;203:501.e1-6.

    PubMed  Google Scholar 

  81. MacFadyen BV, Lenz S. The economic consideration in laparoscopic surgery. Surg Endosc. 1994;8:748–52.

    Article  PubMed  CAS  Google Scholar 

  82. Hasson HM. A modified instrument and method for laparoscopy. Am J Obstet Gynecol. 1971;110:886–7.

    PubMed  CAS  Google Scholar 

  83. Hasson HM. Open laparoscopy: a report of 150 cases. J Reprod Med. 1974;12:234–8.

    PubMed  CAS  Google Scholar 

  84. Penfield AJ. How to prevent complications of open laparoscopy. J Reprod Med. 1985;30:660–4.

    PubMed  CAS  Google Scholar 

  85. Canis M, Mage G, Pouly JL, Wattiez A, Manhes H, Bruhat MA. Laparoscopic diagnosis of adnexal cystic masses: a 12 year experience with long term follow-up. Obstet Gynecol. 1994;83:707–12.

    PubMed  CAS  Google Scholar 

  86. Canis M, Pouly JL, Wattiez A, Mage G, Manhes H, Bruhat MA. Laparoscopic management of adnexal tumours suspicious at ultrasound. Obstet Gynecol. 1997;89:679–83.

    Article  PubMed  CAS  Google Scholar 

  87. Canis M, Rabischong B, Batchorishvili R, Tamburo S, Wattiez A, Mage G, et al. Risk of spread of ovarian cancer after laparoscopic surgery. Curr Opin Obstet Gynecol. 2001;13:9–14.

    Article  PubMed  CAS  Google Scholar 

  88. Ogihara Y, Isshiki A, Kindscher JD, Goto H. Abdominal wall lift versus carbon dioxide insufflation for laparoscopic resection of ovarian tumors. J Clin Anesth. 1999;11:406–12.

    Article  PubMed  CAS  Google Scholar 

  89. Querleu D, Childers JM, Dargent D. Laparoscopic surgery in gynaecological oncology. Malden: Blackwell Science; 1999.

    Google Scholar 

  90. Shepherd JH, Carter PG, Lowe DG. Wound recurrence by implantation of a borderline ovarian tumour following laparoscopic removal. Br J Obstet Gynaecol. 1994;101:265–6.

    Article  PubMed  CAS  Google Scholar 

  91. van Dam PA, DeCloedt J, Tjalma WAA, Buytaert P, Becquart D, Vergote I. Trocar implantation metastasis after laparoscopy in patients with advanced ovarian cancer: can the risk be reduced? Am J Obstet Gynecol. 1999;181:536–41.

    Article  PubMed  Google Scholar 

  92. Leidi L, Brusati M, Vespa MG. A treacherous scar. Am J Obstet Gynecol. 2007;197:553. e1-553. e2.

    Article  PubMed  Google Scholar 

  93. Pelosi 3rd MA, Pelosi MA. Spontaneous uterine rupture at thirty-three weeks subsequent to previous superficial laparoscopic myomectomy. Am J Obstet Gynecol. 1997;177:1547–9.

    Article  PubMed  Google Scholar 

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Gasbarro, N., Brusati, M., Lupo, P., Gerli, S., Di Renzo, G.C. (2012). The Evolution of Minimally Invasive Gynecological Surgery: Gas-Less Laparoscopic Inspection and Single Hole Surgery (GLISHS). In: Tinelli, A. (eds) Laparoscopic Entry. Springer, London. https://doi.org/10.1007/978-0-85729-980-2_10

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