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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Create a free personal account to access your subscriptions, sign up for alerts, and more. In this way unnecessary laparotomies can be avoided. Use of this technique, allows clarification of the diagnosis and also acquisition of the necessary information to determine the appropriate therapeutic approach.

Randomised comparison between low-pressure laparoscopic cholecystectomy and gasless laparoscopic cholecystectomy. Treatment followed in each case, depended on the diagnosis and is presented on Table 2.

The retractor system used is described in detail and involves an intraabdominal device attached to a hydraulic lifting apparatus.

In this gasless laparoscopic procedure, simple valveless trocars and instruments can be used. The other three cases involved intense abdominal pain, in older patients, with severe neurological and cardiological problems, in whom mesenteric ischemia was suspected, but was eventually excluded, without revealing though any obvious cause for the pain.

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. Endosc Surg Allied Technol.

The gasless laparoscopic cholecystectomy. Table 2 Treatment based on diagnosis made by gasless diagnostic laparoscopy.

Create a free personal account to make a comment, download free article PDFs, sign up for alerts and more. Gasless laparoscopic technique of wide excizion for gastric gastrointestinal stromal tumor versus open method. An interesting study by Koivusalo et alshowed that gasless versus classical laparoscopy offers advantages in terms of postoperative recovery: Low-pressure pneumoperitoneum laparoscopic surgery.

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Distension of the abdominal wall with the laparolift method is in a pyramid like shape that creates the effect of a tent and most laparocopy, can be painful Three hospitals were included in this study: Laparolift can be performed in many ways by instruments that, while fixed to the operating table, raise the abdominal wall laparoscopyy.

In this way we performed gasless laparoscopic surgery on 54 patients: Hypercarbia during carbon dioxide insufflation for therapeutic laparoscopy: Regarding the eight patients in which laparoscopy was inconclusive: Support Center Support Center. Paolucci V, Schaeff B eds. Hospital of Obstetrics and Gynecology “I. Number of cases diagnosed by gasless laparoscopy as distributed based on their diagnosis.

The role of gasless laparoscopy in differential diagnosis of acute abdomen

Tec- niche diagnostiche ed operative. Two techniques were used: The indications for the procedures are summarized in Table 1. This aspect of the technique is particularly attractive, since it may lower instrumentation costs and facilitate procedures.

Under direct vision and digital control a fan-formed wall retractor, which is attached to an electric lift arm, is introduced into the abdominal cavity. In such cases, diagnostic laparoscopy may solve the differential diagnostic problem. Gasless laparoscopy in abdominal surgery. The diagnosis of acute abdomen in the emergency setting, still remains a challenging problem.

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 ]. Journal List Hippokratia v. Conclusions Gasless laparoscopy is a useful method for the differential diagnosis of acute abdomen causes in cases of extreme graveness and urgency.

Six times, we had to change the surgical procedure. The alternative actually exists since when Eruheim made the first gasless laparoscopy.

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

Paolucci V, Schaeff B. Conflict of interest Gaslesss authors declare no conflict of interest. Laparoscopia gasless in chirurgia e ginecologia. 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.

In Muhe achieved the first laparoscopic cholecystectomy without pneumoperitoneum. Regarding the anesthesia used in lapafoscopy laparoscopy, it can be either regional or local anesthesia.

The role of gasless laparoscopy in differential diagnosis of acute abdomen

Pneumoperitoneum, as a laparoecopy precondition of laparoscopic procedures, represents a restriction of the surgeon’s freedom of movement and can lead to rare but typical complications.

First Page Preview View Large. Tehnology-driven triage of abdominal trauma: Author information Copyright and License information Disclaimer. Gasless laparoscopy is a useful method for the differential diagnosis of acute abdomen causes in cases laparoscpoy extreme graveness and urgency.

Of interest is the report of a lapwroscopy repair with epidural anesthesia. Requiring only local or regional anesthesia, this technique could easily find application in diagnosis and treatment, while avoiding unnecessary laparotomies. 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 relative gaslesx absolute contraindications to general anesthesia or pneumoperitoneum.

Randomized comparison of conventional and gasless laparoscopic cholecystectomy: Our website uses cookies to enhance your experience. Sign in to access your subscriptions Sign in to your personal account.