Abstract
The term gasless laparoscopy describes the technique of performing laparoscopic procedures without the use of pressurized gas for abdominal distention. In gasless laparoscopy, initial or concurrent gas insufflation is not used; instead, mechanical lifting of the abdominal wall maintains an endoscopic operating cavity. Substitution of mechanical support for pneumoperitoneum allows laparoscopic tools to revert to open surgical instrumentation, as gas sealing is no longer a requirement. This technical difference has significant impact on surgical control and coordination. The potential for performing more complicated endoscopic procedures is increased. The learning curve for new techniques may be decreased. Lasdy, removal of the requirement to maintain full gas insufflation for adequate visualization may increase the safety and reliability of laparoscopic surgery. In gasless laparoscopy, a constant level of visualization is achieved throughout the procedure, independent of gas leakage and application of suction aspiration. We believe that the investment of effort required to learn the technique of gasless laparoscopy is well compensated by the multiple benefits bestowed by this approach.
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References and Recommended Reading
Gazayerli MM: The Gazayerli endoscopic retractor model 1. Surg Laparosc Endosc 1991, 1:98–100.
Semm K, Lehmann-Willenbrock E: Pelvioscopy and laparoscopy without overpressure: the aspiration pneumoperitoneum. In Gasless Laparoscopy in General Surgery and Gynecology. Edited by Paolucci V, Schaeff B. Stuttgart: Thieme; 1996.
Kitano S, Tomikawa M, Iso Y, et al.: A safe and simple method to maintain a clear field of vision during laparoscopic cholecystectomy. Surg Endosc 1992, 6:197–198.
Francois Y, Mouret P: Suspenseur de paroi et coelio-chirugie. J Chir (Paris) 1992, 129:492–493.
Wood C, Maher P, Hill D: Gasless synchronized laparovaginal hysterectomy. Gynecol Endosc 1995, 4:169–172.
Nagai H, Inabo T, Kamiya S, et al.: A new method of laparoscopic cholecystectomy: an abdominal wall lifting technique without pneumoperitoneum [abstract]. Surg Laparosc Endosc 1991, 1:26.
Hashimoto D, Nayeem SA, Kajiwara S, et al.: Laparoscopic cholecystectomy: a new approach without pneumoperitoneum. Surg Endosc 1993, 7:54–56.
Chin AK, Moll FH, McColl MB, et al.: Mechanical peritoneal retraction as a replacement for carbon dioxide pneumoperitoneum. J Am Assoc Gynecol Laparosc 1993, 1:62–66.
Tsoi EKM, Organ CH Jr: Abdominal wall lifting devices as alternatives to pneumoperitoneum. Semin Laparosc Surg 1995, 2:205–208. This is a review article on the initial clinical application of abdominal lifting devices. The authors were members of the investigating team at the University of California, Davis-East Bay department of surgery using the planar lifting technique. This paper provides readers with the perspective of the investigators on this gasless technique.
Chin AK, Moll FH: Balloon-assisted extraperitoneal surgery. In Retroperioneoscopy. Edited by Darzi A. Oxford: Isis Medical Media; 1996.
Myles PS: Bradyarrhythmias and laparoscopy: a prospective study of heart rate changes with laparoscopy. Aust N Z Obstet Gynaecol 1991, 31:171–173.
Doyle DJ, Mark PW: Laparoscopy and vagal arrest. Anesthesiology 1989, 44:448–453.
Pascual JB, Baranda MM, Tarrero MT, et al.: Subcutaneous emphysema, pseudomediastinum, bilateral pneumothorax and pneumopericardium after laparoscopy [letter]. Endoscopy 1990, 22:59.
Kent RB: Subcutaneous emphysema and hypercarbia following laparoscopic cholecystectomy. Arch Surg 1991, 126:1154–1156.
Pearce DJ: Respiratory acidosis and subcutaneous emphysema during laparoscopic cholecystectomy. Can J Anaesth 1994, 41:314–316.
Clark CC, Weeks DB, Gusdon JP: Venous carbon dioxide embolism during laparoscopy. Anesth Analg 1977, 56:650–652.
Yacoub OF, Cardona I, Coveler LA, et al.: Carbon dioxide embolism during laparoscopy. Anesthesiology 1982, 57:533–535.
Beebe DS, McNevin MP, Grain JM, et al.: Evidence of venous stasis after abdominal insufflation for laparoscopic cholecystectomy. Surg Gynecol Obstet 1993, 176;443–447.
Smith RS: Evaluation and treatment of abdominal trauma. In Gasless Laparoscopy in General Surgery and Gynecology. Edited by Paolucci V, Schaeff B. Stuttgart: Thieme; 1996:68–75.
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© 1998 Springer-Verlag Berlin Heidelberg
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Chin, A.K., Tsoi, E.K.M., Organ, C.H. (1998). Gasless Laparoscopy. In: Brooks, D.C. (eds) Current Review of Minimally Invasive Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-1692-6_19
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DOI: https://doi.org/10.1007/978-1-4612-1692-6_19
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4612-7247-2
Online ISBN: 978-1-4612-1692-6
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