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Hand-assisted laparoscopy on a shoestring.

Luke Antony1, Eunice Laim, Sydney S C Chung

  • 1Port Moresby General Hospital, Port Moresby, Papua New Guinea.

ANZ Journal of Surgery
|August 10, 2007
PubMed
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A novel shoestring suture technique offers an inexpensive way to maintain pneumoperitoneum during hand-assisted laparoscopic surgery. This method eliminates the need for specialized equipment in complex laparoscopic procedures.

Area of Science:

  • Minimally Invasive Surgery
  • Surgical Innovation

Background:

  • Hand-assisted laparoscopic surgery (HALS) is valuable for complex laparoscopic procedures.
  • Maintaining pneumoperitoneum in HALS typically requires expensive, specialized airtight devices.
  • Existing methods present challenges in terms of cost and usability.

Observation:

  • A simple technique using a nylon suture was developed to maintain pneumoperitoneum.
  • The suture was tied in a criss-cross fashion at the incision's end.
  • Airtightness was achieved by tightening the suture around the surgeon's wrist and hand.

Findings:

  • The shoestring suture method successfully maintained pneumoperitoneum during a HALS nephrectomy.
  • This technique proved effective and cost-efficient in a clinical case.

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  • The procedure involved the removal of a pyonephrotic kidney.

    • Implications:

    • This low-cost method democratizes access to advanced laparoscopic techniques.
    • It offers a viable alternative to expensive commercial devices for HALS.
    • The technique simplifies the process of maintaining pneumoperitoneum in challenging laparoscopic surgeries.