Gasless laparoscopy for the urologist

PURPOSE: To explore the use of gasless laparoscopy in urology. MATERIALS AND METHODS: Over 120 patients underwent various urological procedures with this technique from September 1994. For extraperitoneal procedures, balloon dissection was used to develop the extraperitoneal space. A mechanical retraction system was used with conventional laparotomy instruments to perform laparoscopic Burch bladder neck suspensions, staging pelvic lymphadenectomies, two-team abdominovaginal slings, nephrectomies, and ureterectomy. RESULTS: Early results indicate that this gasless technique may result in much quicker operative times with similar success rates to the conventional carbon dioxide laparoscopy with respect to bladder neck suspensions. Conversion to an open procedure was also lower with this technique. CONCLUSIONS: Gasless laparoscopic techniques may facilitate urological procedures, and may be easier and quicker to learn. Previous multiple surgeries and excess weight are not contraindications to performing this laparoscopic technique.