Gasless Laparoscopic Surgery for Minimally Invasive Surgery in Low-Resource Settings: Methods for Evaluating Surgical Field of View and Abdominal Wall Lift Force
Journal – Surgical Innovation
Publication date – Oct – 2020
Authors – William S Bolton, Noel K. Aruparayil, Manish Chauhan, William R. Kitchen, Kevin J. N. Gnanaraj, Alice M. Benton, Sophie E. Hutchinson, Joshua R. Burke, Jesudian Gnanaraj, David G. Jayne, and Peter R. Culmer
Keywords – gasless, laparoscopy, minimally invasive
Open access – Yes
Speciality – General surgery
World region Global
Language – English
Submitted to the One Surgery Index on November 14, 2020 at 4:57 am
Laparoscopic surgery has advantages over open surgery for several abdominal conditions due to improved short-term outcomes. Performing laparoscopic surgery in many low and middle-income country (LMIC) settings is restricted by the lack of general anaesthesia (GA) and carbon dioxide (CO2) insufflation. Gasless laparoscopic surgery employs the use of a mechanical anterior abdominal wall lift device to create internal space within the abdomen. This negates the need for GA and CO2 which may help increase adoption of laparoscopic surgery in LMIC settings.
The safety and efficacy of gasless techniques appear to be non-inferior when compared to conventional laparoscopic surgery for many gastrointestinal and gynaecological conditions.3 However, concerns from surgeons before adopting this technique are operative field of view and safety concerns including damage to the abdominal wall during the lift.3 Many lift devices produce a tenting effect, creating an angular cavity that can restrict view. Monitoring to ensure a ‘safe’ force is applied is also essential, as lifting the abdominal wall carries the potential for trauma if too much force is applied. Our aim was to develop methods that may be used in future clinical studies aimed at mitigating these concerns by assessing field of view and force exerted on tissues during gasless lift procedures.
OSI Number – 20754