Gasless Laparoscopy and Conventional Instruments

Smith, R. Stephen; Fry, William R.; Tsoi, Edmund K. M.; Henderson, Vernon J.; Hirvela, Elsa R.; Koehler, Richard H.; Brams, David M.; Morabito, Diane; Peskin, Gerald W.

doi:10.1001/archsurg.1993.01420220022003

Cited by 107 publications

(22 citation statements)

References 10 publications

(1 reference statement)

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“…By eliminating the use of many disposable laparoscopic instruments, hospitals can reduce the costs of treating patients without affecting the standards of patient care. The use of gasless laparoscopy and conventional instruments has also been shown to be safe and cost effective [14]. This would not only lower the variable costs incurred by each patient but also lower the relative proportion of intraoperative costs associated with diagnostic or therapeutic laparoscopy.…”

Section: Discussionmentioning

confidence: 99%

Cost analysis of diagnostic laparoscopy vs laparotomy in the evaluation of penetrating abdominal trauma

1997

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Variable and total costs and length of stay were significantly lower in our population of patients who underwent DL as compared to NL. The rate of negative or nontherapeutic laparotomy was also significantly reduced when compared to the rate identified during the era prior to the use of laparoscopy. Laparoscopy resulted in an overall savings of $1,059 per laparoscopy performed when compared to laparotomy.

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Section: Discussionmentioning

confidence: 99%

Cost analysis of diagnostic laparoscopy vs laparotomy in the evaluation of penetrating abdominal trauma

1997

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“…Various investigators have reported a variety of abdominal wall lifting devices [1,6,8,10,11,13], yet abdominal wall lifting methods have not gained general acceptance. The reasons are as follows: (1) narrow visual field and small operating space due to the straight side wall of the abdominal cavity [14]; (2) the requirement for additional abdominal wounds and potential for increased postoperative pain; and (3) the time required for preoperative assembly of the retractor system.…”

Section: Discussionmentioning

confidence: 99%

Development and clinical application of semi-loop-shaped retractor for gasless laparoscopic surgery

2003

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“…Conventional surgical instruments could be easily used when needed [13]. The assembly was inexpensive and manufactured locally.…”

Section: Discussionmentioning

confidence: 99%

Modified Technique of Gasless Laparoscopic Cholecystectomy in a Developing Country: A 5-Year Experience

Nande¹,

Shrikhande²,

Rathod³

et al. 2002

Dig Surg

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Background: Concerns and disadvantages associated with pneumoperitoneum have led surgeons to search for alternative techniques of exposure in laparoscopic surgery. We devised a modified technique of gasless laparoscopic cholecystectomy based on the concept of mechanical retraction of the abdominal wall. Patients and Methods: 337 males and 663 females, mean age 52 (7–87) years and mean weight 68 (28–126) kg, with gallstone disease and subjected to this technique were evaluated retrospectively (1992–1997). Towel clips were applied at 3 points on the abdominal wall and it was lifted without creating a pneumoperitoneum. A single surgical team specialized and experienced in biliary surgery performed all the surgeries. Results: Of 1,000, 46 patients weighing more than 85 kg required a combination of mechanical abdominal wall retraction and minimal pressure pneumoperitoneum (5 mm Hg). The conversion rate was 6% but none were related to limitations of the technique. Technique-related morbidity was minimal. No common bile duct or visceral injury was recorded and mortality was 0%. Conclusion: Gasless laparoscopic cholecystectomy is a feasible, safe and effective alternative to the pneumoperitoneum technique. It probably costs less and is therefore more useful in developing countries. However, it has limitation in overweight patients who are infrequently encountered in our population.

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Gasless Laparoscopy and Conventional Instruments

Cited by 107 publications

References 10 publications

Cost analysis of diagnostic laparoscopy vs laparotomy in the evaluation of penetrating abdominal trauma

Cost analysis of diagnostic laparoscopy vs laparotomy in the evaluation of penetrating abdominal trauma

Development and clinical application of semi-loop-shaped retractor for gasless laparoscopic surgery

Modified Technique of Gasless Laparoscopic Cholecystectomy in a Developing Country: A 5-Year Experience

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