Gasless Laparoscopic Cholecystectomy in a Pig Using a Self-Designed Umbrella-Like Abdominal Wall-Lifting Device

Abstract

Introduction:

In laparoscopic surgery with CO₂ pneumoperitoneum, serious complications often occur for elderly patients and those who undergo long operations. ¹ These complications mainly include respiratory and circulatory system changes. ^{2 –4} In patients with tumors, release of free tumor cells into the abdominal cavity is believed to be possible. ⁵ Gasless laparoscopic techniques can avoid these complications of CO₂ pneumoperitoneum. Currently, the main shortcoming of gasless laparoscopic techniques is the inadequate operative space. Because of this shortcoming, gasless techniques have not been widely applied in clinical practice.

Case Report:

In the video, we describe a new technique of gasless laparoscopic cholecystectomy in a pig using a self-designed umbrella-like abdominal wall-lifting device. The umbrella was constructed from stainless steel and was 150 mm in diameter. Ten spokes formed an umbrella through a folding movement. This device lifted up the anterior abdominal wall by opening the umbrella leaf in the abdominal cavity. The male Bama miniature pig weighed 29 kg. The operation time was 28 minutes. Because of mechanical irritation of the abdomen, long operations over 2 hours seemed not the right indication for the umbrella device.

Conclusion:

This work suggests that the umbrella-like abdominal wall-lifting technique is safe and feasible in gasless laparoscopic surgery for not long operations and can provide sufficient exposure of the operative field.

This work was supported by National Natural Science Fund Projects (No. 581160187).

No competing financial interests exist.

Runtime of video: 2 mins 57 secs.