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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The combination of the risk of an open laparotomy and the relative high likelihood of negative findings when performed, creates the need for a better approach.
The role of gasless laparoscopy in differential diagnosis of acute abdomen
In this way unnecessary laparotomies can be avoided. 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.
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. Laparoscopia gasless in chirurgia e ginecologia. For these 49 procedures, two methods were used: The majority of experience has been in cholecystectomy, with fewer la;aroscopy done for hernia and colon resection.
Regarding the eight patients in which laparoscopy was inconclusive: Discussion Laparoscoph use of gasless laparoscopy has a number of advantages resulting from the lack of side effects and complications caused by the creation of pneumoperitoneum by CO 2 2.
The disadvantages of carbon dioxide pneumoperitoneum, some real and some hypothetical, are noted.
The alternative actually exists since when Eruheim made the first gasless laparoscopy. The indications laparroscopy the procedures are summarized in Gaslesw 1. The use of gasless laparoscopy has a number of advantages resulting from the lack of side effects and complications caused by the creation of pneumoperitoneum by CO 2 2.
Open in a separate window. It has to be mentioned though that neither this technique is free of complications. Sign in to customize your interests Sign in to your personal account. The retractor system used is described in detail and involves an intraabdominal device attached to a hydraulic lifting apparatus.
Gasless Laparoscopy With Conventional Instruments: The Next Phase in Minimally Invasive Surgery
Six times, we had to change the surgical procedure. Download the Laparoscopyy to view the article, as well as its associated figures and tables.
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. Use of this technique, allows clarification of the diagnosis and also acquisition of the necessary information to determine the appropriate therapeutic approach.
Requiring only local or regional anesthesia, this technique could easily find application in diagnosis and treatment, while avoiding unnecessary laparotomies. Introduction 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 ].
Sign in to access your subscriptions Sign in to your personal account. Table 2 Treatment based on diagnosis made by gasless diagnostic laparoscopy.
Create a personal account to register for email alerts with links to free full-text articles. We chose a sui-generis alternative, in which an incision is made about 2 laparosscopy from the base of the navel, the abdominal wall is afterwards raised with two Kocher clamps and the laparoscope is introduced in the abdominal cavity. CopyrightHippokratio General Hospital of Thessaloniki. Randomized comparison of conventional and gasless laparoscopic cholecystectomy: Author information Laparosckpy and License information Disclaimer.
Gasless laparoscopy in abdominal surgery.
Gasless laparoscopy performed by both methods has some disadvantages as well. It is though under consideration, once our experience is advanced, to use this method for therapeutic applications in the future. Articles from Hippokratia are provided here courtesy of Hippokratio General Hospital of Thessaloniki.
Hypercarbia during carbon dioxide insufflation for therapeutic laparoscopy: