By Daniel Kruschinski
Physiologically, gasless laparoscopy is much less invasive than pneuomoperitoneum insufflation, permitting the physician to accomplish laparoscopic surgical procedure in high-risk sufferers with stipulations corresponding to middle insufficiency, lung obstruction, and being pregnant.
Exploring some great benefits of lift-laparoscopy and its cost-effectiveness for sufferers, surgeons, hospitals, and the healthcare approach, this article discusses the demanding situations concerned with gasless laparoscopy, the diversity of purposes of the tactic, and new demanding situations within the box. With whole insurance of surgeries, An Atlas of carry Laparoscopy is a worthy consultant to utilizing this minimally invasive surgical procedure.
Read or Download Atlas of Lift-Laparoscopy: The New Concept of Gasless Laparoscopy (Encyclopedia of Visual Medicine Series) PDF
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Additional info for Atlas of Lift-Laparoscopy: The New Concept of Gasless Laparoscopy (Encyclopedia of Visual Medicine Series)
Lowering the position of the Abdo-Lift™ can be performed by the height adjusting wheel. Then, the ancillary trocars should be withdrawn under visual control. 26 The abdominal cavity can then be elevated using one hand while the other hand is holding the endoscope. The trocar sheath is removed from the incision while the optic remains in the abdomen. 27 To prevent hernia formation, the fascia of the umbilical and ancillary ports should be closed. Closure of ancillary ports should be performed under endoscopic visualization.
A rectal probe can also be introduced for manipulation and better visualization of the rectum, and identification of the recto-vaginal septum during extensive laparoscopic resection. For gasless laparoscopy it is recommended that the bowel be prepared as for laparotomy, in the case that not only a diagnostic procedure but also operative surgery is to be performed. If extensive surgery is likely to be carried out, and bowel manipulation or injury anticipated, as in the case of extensive adhesions or endometriosis, it is advisable to administer a mechanical bowel preparation prior to surgery.
40 New bipolar instruments for use in lift-laparoscopy (Bissinger, Germany) are in the process of design and manufacture. 41 A bipolar clamp enables grasping and coagulation with the same instrument. 43 With the bipolar clamp, tissue can be grasped while coagulation and cutting are performed by the bipolar scissors. 1 For gynecologic procedures the Abdo-Lift™ is located on the right side of the patient at shoulder height and is mounted on the rail of the operating table. Shoulder braces allow a deep Trendelenburg position and prevent sliding of the patient.