Gasless or Lift Laparoscopic Surgery Equipment: A Comparison of Available Options

By Dr. J. Gnanaraj, Ms. Danita Gnanaraj, Kevin Gnanaraj, Mr. Staan Maria Albert, Mr. L. R. Bravin

Minimally invasive laparoscopic surgery ranks similar to the introduction of anesthesia for surgeries, in creating a significant impact on surgical care. Healthy patients can tolerate the effects of CO2 pneumoperitoneum well, but compromised patients may have life-threatening consequences, such as cardiac arrhythmia, myocardial infarction, cardiac failure, or pulmonary insufficiency (1). Pneumoperitoneum, as a necessary precondition of laparoscopic procedures, in addition to causing several physiological changes, has a small but definite possibility of complications (2). Several animal studies have documented the problems associated with the use of carbon dioxide insufflation, and hence the superiority of gasless or “lift” laparoscopic surgeries (3-7). However, the initial experience with gasless laparoscopic surgeries has shown that surgeries carried out with gasless laparoscopy are more difficult technically than those with pneumoperitoneum. This is because of impaired visualization from the bowel in the pelvis. Operating times can be longer, and the cost of treatment per case can increase due to equipment such as Laparolift or the disposable Laparofan. (8).
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