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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Low-pressure pneumoperitoneum laparoscopic surgery. The authors’ analysis of gasless laparoscopy is informative and gives the reader a historical perspective of this evolving technique.
A randomized comparison of gasless laparoscopic appendectomy and conventional laparoscopic appendectomy. In two of these patients, pain was reported at the lapxroscopy site 3 weeks after surgery. Table 2 Treatment based on diagnosis made by gasless diagnostic laparoscopy.
Gasless laparoscopy in abdominal surgery.
In cholecystectomy and bowel resection the advantages of being able to use traditional instruments are stressed. Both gasless lapzroscopy have the advantage of avoiding general anesthesia, requiring only local or regional anesthesia. This author and others 1 – 6 used exclusively the laparolift method, with the LapVision variant not being mentioned.
After raising the abdominal wall, the scope is introduced through the same access gaslese the laparoscopic procedure can be started without the technical and physiopathological problems which may occur using a pneumoperitoneum. The retractor system used is described in detail and involves an intraabdominal device attached to a hydraulic lifting apparatus.
The differential diagnosis of acute abdomen remains a complex clinical issue because, on one hand the patient involved could be already compromised and the time available for diagnosis limited, and on the other hand due to frequent lack of diagnostic means [computed tomography CTmagnetic resonance imaging MRIultrasonography US ]. Discussion The use of gasless laparoscopy has a number of advantages resulting from the lack of side effects laparosscopy complications caused by the creation of pneumoperitoneum by CO 2 2.
In this way unnecessary laparotomies can be avoided. First Page Preview View Large. 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.
The role of gasless laparoscopy in differential diagnosis of acute abdomen
Especially in six cases treated this way, the postoperative pain was very intense and high doses of painkillers were required. Register for email alerts with links to free full-text articles Access PDFs of free articles Manage your interests Save searches and receive search alerts. Purchase access Subscribe laaproscopy the journal. Create a free personal account to access your subscriptions, sign up for alerts, and more.
Distension of the abdominal wall with the laparolift method is in a pyramid like shape that creates the effect of a tent and most importantly, can be painful Create a personal account to register for email alerts with links to free full-text articles. Number of cases diagnosed by gasless laparoscopy as distributed based on their diagnosis. The diagnosis of acute abdomen in the emergency setting, still remains a challenging problem. Final diagnoses were established in 41 patients and gqsless presented in detail in Figure 1while tasless eight patients no obvious cause was identified or existed.
First of all, the view is somewhat inadequate, especially in the lateral and inferior quadrants. Randomized comparison of conventional and gasless laparoscopic cholecystectomy: Regarding the anesthesia used in gasless laparoscopy, it can be either regional or local anesthesia.
Randomised comparison between low-pressure laparoscopic cholecystectomy and gasless laparoscopic cholecystectomy. During anesthesia, neither increased ventilation nor increased ventilation pressure is necessary, and the surgeon has increased freedom of action.
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. Compared to the traditional procedure with a CO2 pneumoperitoneum, the results of the first gasless procedures demonstrate potential advantages.
Regarding the eight patients in which laparoscopy was inconclusive: Regarding the issue of gasless laparoscopic surgery, the available studies in the literature are relatively few and the largest series published are comparable to ours. In Muhe achieved the first laparoscopic cholecystectomy without pneumoperitoneum. Also a study of Ge et al, in cases of appendectomies performed by gasless laparoscopy showed significantly decreased hospital costs 8. Three hospitals were included in this study: Laparoscopy, gasless laparoscopy, emergency, contraindications.
Gasless laparoscopy in abdominal surgery.
Hippokratia19 1: Material and Methods Three hospitals were included in this study: Purchase access Subscribe to JN Learning for one year. The method is not novel, but is currently revalorized in the above described context, and used more frequently. Gasless laparoscopic technique of wide excizion for gastric gastrointestinal stromal tumor versus open method.
New Orleans, Louisiana, September In these patients, diagnostic gasless laparoscopy that identifies hemoperitoneum should be followed by laparotomy. We chose a sui-generis alternative, in which an gaslesd is made about 2 cm from the base of the navel, the abdominal wall is afterwards raised with two Kocher clamps and the gadless is introduced in the abdominal cavity. 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.
The indications for the procedures are summarized in Table 1. We describe lapwroscopy first experiences with laparoscopic surgery without using pneumoperitoneum.