Abstract
We describe our experience with laparoscopic surgery without pneumoperitoneum using the Laparolift system (Origin Medsystem Inc., CA, USA). Under digital control a fan-shaped wall retractor, which is attached to an electric lever, is introduced into the abdominal cavity. After raising the abdominal wall, the scope is introduced through the same access and the laparoscopic procedure can be started without the technical and physiopathological problems which may occur using a pneumoperitoneum. In this gasless laparoscopic procedure, simple valveless trocars and instruments can be used. We performed gasless laparoscopic surgery in 50 patients for cholecystectomy (n = 36), abdominal exploration (n = 8), fenestration of liver cysts (n = 5), and appendectomy (n = 1). We observed two wound infections as related complications. In six cases we had to change the surgical procedure. Compared to the traditional procedure with a CO2 pneumoperitoneum, the results of the first gasless procedures demonstrate possible advantages.
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