Safety and efficiency of gasless laparoscopy: a systematic review protocol

Haitham Shoman,David Ljungman,Simone Sandler,Shauna Trinh,William Bolton,Alexander Peters,Abubakar Abioye,James Little,Magdalen Gruendl,Ameer Farooq,Alex Woods

doi:10.1186/s13643-020-01365-y

Abstract

BackgroundGasless laparoscopy, developed in the early 1990s, was a means to minimize the clinical and financial challenges of pneumoperitoneum and general anaesthesia. It has been used in a variety of procedures such as in general surgery and gynecology procedures including diagnostic laparoscopy. There has been increasing evidence of the utility of gasless laparoscopy in resource limited settings where diagnostic imaging is not available. In addition, it may help save costs for hospitals. The aim of this study is to conduct a systematic review of the available evidence surrounding the safety and efficiency of gasless laparoscopy compared to conventional laparoscopy and open techniques and to analyze the benefits that gasless laparoscopy has for low resource setting hospitals.MethodsThis protocol is developed by following the Preferred Reporting Items for Systematic review and Meta-Analysis–Protocols (PRISMA-P). The PRISMA statement guidelines and flowchart will be used to conduct the study itself. MEDLINE (Ovid), Embase, Web of Science, Cochrane Central, and Global Index Medicus (WHO) will be searched and the National Institutes of Health Clinical Trials database. The articles that will be found will be pooled into Covidence article manager software where all the records will be screened for eligibility and duplicates removed. A data extraction spreadsheet will be developed based on variables of interest set a priori. Reviewers will then screen all included studies based on the eligibility criteria. The GRADE tool will be used to assess the quality of the studies and the risk of bias in all the studies will be assessed using the Cochrane Risk assessment tool. The RoB II tool will assed the risk of bias in randomized control studies and the ROBINS I will be used for the non-randomized studies.DiscussionThis study will be a comprehensive review on all published articles found using this search strategy on the safety and efficiency of the use of gasless laparoscopy. The systematic review outcomes will include safety and efficiency of gasless laparoscopy compared to the use of conventional laparoscopy or laparotomy.Trial registrationThe study has been registered in PROSPERO under registration number: CRD42017078338

Highlights

Gasless laparoscopy, developed in the early 1990s, was a means to minimize the clinical and financial challenges of pneumoperitoneum and general anaesthesia
Conventional laparoscopy has a variety of benefits over open laparotomy [5] and can reduce pain [6], reduce wound infection [7], promote faster postoperative recovery [8], and return to quality of life [9]
The safety of gasless laparoscopy will be reflected through three categories

Summary

Introduction

Gasless laparoscopy, developed in the early 1990s, was a means to minimize the clinical and financial challenges of pneumoperitoneum and general anaesthesia It has been used in a variety of procedures such as in general surgery and gynecology procedures including diagnostic laparoscopy. There has been increasing evidence of the utility of gasless laparoscopy in resource limited settings where diagnostic imaging is not available. It may help save costs for hospitals. Abdominal surgical conditions comprise a burden of disease that cannot be calculated, according to the World Bank’s DCP-3, due to a lack of data [2]. Conventional laparoscopy has a variety of benefits over open laparotomy [5] and can reduce pain [6], reduce wound infection [7], promote faster postoperative recovery [8], and return to quality of life [9]

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