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Patrick F Leahy¹

¹Chief of Surgery, The Laser Centre Clinic, Dublin, Ireland.

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Summary

New devices enable gasless laparoscopic surgery, creating a superior abdominal space without carbon dioxide insufflation. This innovation enhances surgical visualization and reduces environmental impact from surgical gas release.

Keywords:

colorectal surgery gas-less surgery gastric surgery general surgery isobaric laparoscopic

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Area of Science:

Surgical Innovation
Minimally Invasive Surgery
Biomedical Engineering

Background:

Laparoscopic surgery relies on carbon dioxide (CO2) insufflation, creating plumes with potential viral contaminants and obscuring visualization.
CO2 insufflation poses risks including emboli, pain, and physiological complications, and contributes significantly to greenhouse gas emissions.
Current CO2 insufflation methods in minimally invasive surgery present safety and environmental concerns.

Purpose of the Study:

To develop and evaluate a novel system for gasless laparoscopic surgery.
To create a safe and effective alternative to carbon dioxide insufflation in laparoscopic procedures.
To address the safety and environmental drawbacks associated with traditional laparoscopic surgery.

Main Methods:

The gasless surgical system was designed using tensegrity and geodesic dome pressure algorithms.
Extensive simulator studies (100) were conducted for device development and abdominal wall elevation.
Pre-clinical evaluation included 4 animal studies and 3 human cadaveric studies.

Main Results:

The developed device successfully created a superior intra-abdominal space without CO2 insufflation in human cadaveric models.
Simulator and pre-clinical studies demonstrated the feasibility and safety of the gasless approach.
The system proved effective for Laparoscopic Surgery, Robotic Surgery, and Hand Assisted Laparoscopic Surgery (HALS).

Conclusions:

The novel devices enable creation of an adequate intra-abdominal space for laparoscopic procedures without CO2 insufflation.
This gasless approach offers a safer alternative, mitigating risks associated with CO2 insufflation.
The technology is patented in the USA and Europe, paving the way for wider adoption.