Abdominal Wall Lifting Devices as Alternatives to Pneumoperitoneum

Area of Science:

• Minimally Invasive Surgery
• Surgical Technology

Background:

• Conventional laparoscopy relies on pneumoperitoneum (CO2 insufflation) for abdominal wall elevation, which can cause physiological side effects.
• Current laparoscopic techniques often require specialized instruments and surgeon retraining for video-based operations.

Purpose of the Study:

• To introduce and evaluate a gasless laparoscopic technique using mechanical devices for abdominal wall elevation.
• To assess the feasibility of using conventional surgical instruments and direct visualization with this new method.

Main Methods:

• Investigated mechanical devices to elevate the abdominal wall, eliminating the need for pneumoperitoneum.
• Employed conventional surgical instruments and allowed for direct visualization of abdominal viscera.

Main Results:

• The gasless technique enables direct visualization and digital examination of abdominal contents without loss of exposure.
• Reduced risk of body fluid contamination to the operating team due to an isobaric abdominal cavity.
• Facilitated a minimal transition from open to laparoscopic surgery, allowing use of conventional instruments.

Conclusions:

• Gasless laparoscopy offers a viable alternative to CO2 pneumoperitoneum, mitigating physiological side effects.
• This technique simplifies surgical procedures by allowing direct visualization and use of standard instruments.
• It is recommended for inclusion in surgical training programs for future surgeons.