Gasless laparoscopic cholecystectomy is not moretime-consuming

Ortiz-Oshiro, Elena; Mayol, Julio; Medrano, Jose Carlos Aparicio; Ruiz, L. Rabadán; García, Mónica; Fdez-Represa, J. Alvarez

doi:10.1007/s004640090093

Cited by 8 publications

(2 citation statements)

References 10 publications

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“…For all other procedures only a qualitative analysis was performed. Data extracted from all 43 included articles are shown in Table 4 15,16,19,28,29,33,39–74 …”

Section: Resultsmentioning

confidence: 99%

Gasless laparoscopy versus conventional laparoscopy and laparotomy: A systematic review on the safety and efficiency

et al. 2023

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BackgroundGasless laparoscopy (GL) emerged to overcome the clinical and financial challenges of pneumoperitoneum and is often seen as a viable option for use in resource‐limited settings as a means of saving costs and resources. This study aims to systematically review the evidence available on the safety and efficiency of GL compared with conventional laparoscopy (CL) and laparotomy.MethodsFollowing the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, Medline, Embase, Web of Science and Cochrane databases were searched. Variables of interest were determined a priori and Covidence software was used to screen studies for inclusion without demographic preference. The quality of studies was assessed using the Cochrane Risk Assessment tool.ResultsOf the 1080 studies screened, a total of 43 studies were included. Laparoscopic cholecystectomy was by far the most studied intervention in randomised studies. In these, the mean setup time for gasless and CL was 13.14 (95% CI −0.16 to 26.44) and 12.8 (95% CI −10.86 to 36.47) minutes, respectively. The mean duration of surgery for gasless and CL was 89.39 (95% CI 77.44 to 101.34) and 72.59 (95% CI 63.44 to 81.74) minutes, respectively, and the mean length of stay was 4.25 (95% CI 2.02 to 6.48) and 4.04 (95% CI 1.72 to 6.36) days, respectively. Most reported complications were haemorrhage and infection with no assessable statistical difference.ConclusionsAlthough GL seems to be a feasible approach for many general surgery interventions, the observed outcomes based on safety and efficiency are not sufficient to recommend GL as an alternative to CL or laparotomy. Larger randomised trials with a low risk of bias are warranted.

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“…For all other procedures only a qualitative analysis was performed. Data extracted from all 43 included articles are shown in Table 4 15,16,19,28,29,33,39–74 …”

Section: Resultsmentioning

confidence: 99%

Gasless laparoscopy versus conventional laparoscopy and laparotomy: A systematic review on the safety and efficiency

et al. 2023

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“…The operating time was longer in GL group (p=0.038), and this is in accordance with other investigators 18,34 in non-pregnant patients. On the other hand, non-significant difference in the operating time in comparing pneumoperitoneal group to abdominal wall lift group was noticed by Alijani et al, 35 Galizia et al 36 and Ortiz-Oshhiro et al 37 The later in his comparison, divided the operating time into phase 1, which is the time employed to create the surgical field and phase 2, which is the actual operating time. This difference between studies may be explained by the use of different methods to create gasless space from one side and on the other side due to the difference in defining the "start-end" points for time calculation.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of laparoscopic cholecystectomy during pregnancy: A comparative study between low-pressure and gasless laparoscopy

El-Ashry

Mohamed

2009

Ain Shams Journal of Surgery

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Pregnancy and high parity increase the risk of cholelithiasis and its complications during pregnancy. Laparoscopic cholecystectomy for failed conservative treatment of symptomatic cases during pregnancy is no longer been a contraindication. The potential risk of pneumoperitoneal pressure and CO2 insufflation triggered the use of modified techniques as gasless and low pressure cholecystectomy for materno-fetal safety.Patients and methods: Thirteen pregnant patients with indicated cholecystectomy were randomly assigned for either low-pressure laparoscopy (LPL) (6 patients) or gasless laparoscopy (GL) (7 patients). Patients were compared for respiratory and blood gases changes, hemodynamic changes, anesthetic requirements, surgical and early postoperative outcomes and materno-fetal well-being during hospitalization and they were followed up till delivery.Results: After CO2 insufflation there were significant differences between the 2 groups with increase in the cardiopulmonary parameters namely; PaCO2, PetCO2 , peak airway pressure, heart rate and the mean arterial blood pressure and a decrease in pH in the LPL group. The operating time and anesthetic drugs used were significantly more for the GL group. No recorded differences in the postoperative abdominal pain, postoperative nausea and vomiting (PONV) and fetal heart rate changes.Conclusion: Both low pressure and gasless laparoscopy provide a safe technique for laparoscopic cholecystectomy during pregnancy. However, gasless technique is associated with lower cardiopulmonary effects, despite its longer operating time. In patients with compromised cardiopulmonary function during pregnancy, the gasless technique provides a safer method to avoid the potential adverse effects of pneumoperitoneal pressure and CO2 insufflation.

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Abdominal lift for laparoscopic cholecystectomy

Gurusamy

Samraj

Davidson

2008

Cochrane Database of Systematic Reviews

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(1) Abdominal wall lift seems safe and decreases the cardiopulmonary changes associated with laparoscopic cholecystectomy.(2) Abdominal wall lift does not seem to offer advantage over pneumoperitoneum in any of the patient-oriented outcomes for laparoscopic cholecystectomy in patients with low anaesthetic risk and may increase costs by increasing the operating time. Hence it cannot be recommended routinely. More research on the topic is needed.

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Gasless laparoscopic cholecystectomy is not moretime-consuming

Abstract: We found no statistically significant difference between the PP CO2 and AWR groups in either time spent to create the surgical field or actual operating time.

Cited by 8 publications

References 10 publications

Gasless laparoscopy versus conventional laparoscopy and laparotomy: A systematic review on the safety and efficiency

Gasless laparoscopy versus conventional laparoscopy and laparotomy: A systematic review on the safety and efficiency

Safety and efficacy of laparoscopic cholecystectomy during pregnancy: A comparative study between low-pressure and gasless laparoscopy

Abdominal lift for laparoscopic cholecystectomy

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