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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Sign in to download free article PDFs Sign in to access your subscriptions Sign in to your personal account. Gasless laparoscopy performed by both methods has some disadvantages as well. Compared to the traditional procedure with a CO2 pneumoperitoneum, the results of the first gasless procedures demonstrate potential advantages.

The role of gasless laparoscopy in differential diagnosis of acute abdomen

In this way unnecessary laparotomies can be avoided. Two techniques were used: Gasless laparoscopy is the laparoscopic procedure in which, instead of pneumoperitoneum, the operational space in the abdomen is created by various mechanical means that raise the abdominal wall.

Patients with acute abdomen, traumatic or not, where diagnosis is uncertain, in the setting of 13 Our website uses cookies to enhance your experience. Final diagnoses were established in laparosocpy patients and are presented in detail in Figure 1while in eight patients no obvious cause was identified or existed.

The role of gasless laparoscopy in differential diagnosis of acute abdomen

Currently, this technique is used in emergency surgery, especially in debilitated patients and in gynecological cases with uncertain ggasless. In these cases timely diagnosis and management is of great importance, while the anesthetic risk is high.

Especially in six cases treated this way, the postoperative pain was very intense and high doses of painkillers were required. Then, the balloon is inflated and a 3. Articles from Hippokratia are provided here courtesy of Hippokratio General Hospital of Thessaloniki. Six times, we laaproscopy to change the surgical procedure.


Gasless laparoscopy in abdominal surgery.

Laparoscopia gasless in chirurgia e ginecologia. Hospital of Obstetrics and Gynecology “I. Hippokratia19 1: For these 49 procedures, two methods were used: Privacy Policy Terms of Use. The diagnosis of acute abdomen in the emergency setting, still remains a challenging problem. Please review our privacy policy.

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. Sign in to make a comment Sign in to your personal account.

Gasless Laparoscopy With Conventional Instruments: The Next Phase in Minimally Invasive Surgery

Purchase access Subscribe to JN Learning for one year. Gasless laparoscopy in abdominal surgery. 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. Another advantage is that this method uses only local or regional anesthesia, laparoscopt makes it possible to be performed easily, even on the emergency department setting.

Randomised comparison between low-pressure laparoscopic cholecystectomy and gasless laparoscopic cholecystectomy. Conflict of interest The authors declare no conflict of interest. This study included 49 patients that were managed with gasless laparoscopy for gasleds diagnosis of acute abdomen, from to Changes in intracranial hemodynamics during standard pneumoperitoneum for laparoscopy. The aim of this study is to put back into the spotlight, gasless laparoscopy in the differential diagnosis of acute abdomen and to underline the advantages of this simple, cheap and very useful technique, especially in patients that require prompt diagnosis and have agsless or absolute contraindications to general anesthesia or pneumoperitoneum.

Not only special laparoscopic instruments, but the conventional instruments, used in open surgery, can also lapraoscopy employed in gasless laparoscopy.

Author information Copyright and License information Disclaimer. LapVision system has the additional advantage that it does not exert traction on the abdominal wall 9 which results in reduced pain, its flexible trocar can be left in place for drainage, or for the possibility of an easy second look laparoscopy, and additionally the system allows the performance of biopsies through the biopsy channel attached to the trocar.


Based on our experience and local guidelines applied, gasless laparoscopy is currently in use in our institutions only for diagnostic purposes and this results in managing these cases either with gas laparoscopy or with laparotomy. 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 ].

Purchase access Subscribe now. Requiring only local or regional anesthesia, this technique could easily find application in diagnosis and treatment, while avoiding unnecessary laparotomies. In two of these patients, pain was reported at the trocar site 3 weeks after surgery.

Three hospitals were included in this study: In such cases, diagnostic laparoscopy may solve the differential diagnostic problem. Material and Methods Three hospitals were included in this study: The majority of experience has been in cholecystectomy, with laparozcopy operations done for hernia and colon resection.

Create a free personal account to download free article PDFs, sign up for alerts, customize your interests, and more. In Muhe achieved the first laparoscopic cholecystectomy without pneumoperitoneum. The disadvantages of carbon dioxide pneumoperitoneum, some real and some hypothetical, are noted. Get free access to newly published articles Create a personal account or lapraoscopy in to: Paolucci V, Schaeff B.