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Gasless single-port access laparoscopy using a J-shaped retractor in patients undergoing adnexal surgery

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Abstract

Objective

The aim of this study was to compare gasless single-port access (SPA) laparoscopy using a J-shaped retractor and conventional SPA laparoscopy in patients undergoing adnexal surgery.

Study design

The medical records of 80 patients who underwent laparoscopic adnexal surgery between May 2017 and April 2019 were reviewed. Of the 80 patients, 40 patients underwent gasless SPA laparoscopy using a J-shaped retractor and 40 underwent conventional SPA laparoscopy. All surgeries were performed by one laparoscopic surgeon. Surgical outcomes were compared between the two groups.

Results

There are no significant differences in age, body mass index, parity, previous abdominal surgery, tumor marker, and tumor diameter between the gasless and conventional groups. The median retraction setup time from skin incision was 7 min (range 5–12 min) in gasless SPA laparoscopic adnexal surgery. The median total operation times were 55.5 min (range 30–155 min) in the gasless group and 55 min (range 30–165 min) in the conventional group without a significant difference. Additionally, there were no differences in operation type, conversion rate of laparotomy, use of an additional trocar, and pathological outcomes between the two groups. No major complications, such as urologic, bowel, and vessel injuries, were found in both groups.

Conclusions

Gasless SPA laparoscopy using a J-shaped retractor appears to offer a better alternative to conventional SPA laparoscopy that avoids the potential negative effects of carbon dioxide gas in selected cases.

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References

  1. Yuen PM, Yu KM, Yip SK, Lau WC, Rogers MS, Chang A (1997) A randomized prospective study of laparoscopy and laparotomy in the management of benign ovarian masses. Am J Obstet Gynecol 177(1):109–114

    Article  CAS  Google Scholar 

  2. Pelosi P, Foti G, Cereda M, Vicardi P, Gattinoni L (1996) Effects of carbon dioxide insufflation for laparoscopic cholecystectomy on the respiratory system. Anaesthesia 51(8):744–749

    Article  CAS  Google Scholar 

  3. Dorsay DA, Greene FL, Baysinger CL (1995) Hemodynamic changes during laparoscopic cholecystectomy monitored with transesophageal echocardiography. Surg Endosc 9(2):128–133 (discussion 33-4)

    Article  CAS  Google Scholar 

  4. McLaughlin JG, Scheeres DE, Dean RJ, Bonnell BW (1995) The adverse hemodynamic effects of laparoscopic cholecystectomy. Surg Endosc 9(2):121–124

    Article  CAS  Google Scholar 

  5. Son JS, Oh JY, Ko S (2017) Effects of hypercapnia on postoperative nausea and vomiting after laparoscopic surgery: a double-blind randomized controlled study. Surg Endosc 31(11):4576–4582

    Article  Google Scholar 

  6. Yasir M, Mehta KS, Banday VH, Aiman A, Masood I, Iqbal B (2012) Evaluation of post operative shoulder tip pain in low pressure versus standard pressure pneumoperitoneum during laparoscopic cholecystectomy. Surgeon 10(2):71–74

    Article  Google Scholar 

  7. Smith RS, Fry WR, Tsoi EK, Henderson VJ, Hirvela ER, Koehler RH et al (1993) Gasless laparoscopy and conventional instruments. The next phase of minimally invasive surgery. Arch Surg. 128(10):1102–1107

    Article  CAS  Google Scholar 

  8. Akira S, Abe T, Igarashi K, Nishi Y, Kurose K, Watanabe M et al (2005) Gasless laparoscopic surgery using a new intra-abdominal fan retractor system: an experience of 500 cases. J Nippon Med Sch 72(4):213–216

    Article  Google Scholar 

  9. Takeda A, Imoto S, Nakamura H (2014) Gasless laparoendoscopic single-site surgery for management of adnexal masses during pregnancy. Eur J Obstet Gynecol Reprod Biol 180:28–34

    Article  Google Scholar 

  10. Pellegrino A, Damiani GR, Tartagni M, Speciale D, Villa M, Sportelli C et al (2013) Isobaric laparoscopy using LaparoTenser system in surgical gynecologic oncology. J Minim Invasive Gynecol 20(5):686–690

    Article  Google Scholar 

  11. Ulker K, Huseyinoglu U, Kilic N (2013) Management of benign ovarian cysts by a novel, gasless, single-incision laparoscopic technique: keyless abdominal rope-lifting surgery (KARS). Surg Endosc 27(1):189–198

    Article  Google Scholar 

  12. Demirayak G (2017) A different technique in gasless laparoendoscopic single-site hysterectomy. J Obstet Gynaecol 37(5):622–626

    Article  Google Scholar 

  13. Sesti F, Pietropolli A, Sesti FF, Piccione E (2013) Uterine myomectomy: role of gasless laparoscopy in comparison with other minimally invasive approaches. Minim Invasive Ther Allied Technol 22(1):1–8

    Article  Google Scholar 

  14. Schmitt A, Crochet P, Knight S, Tourette C, Loundou A, Agostini A (2017) Single-port laparoscopy vs conventional laparoscopy in benign adnexal diseases: a systematic review and meta-analysis. J Minim Invasive Gynecol 24(7):1083–1095

    Article  Google Scholar 

  15. Takeda A, Sakai K, Mitsui T, Nakamura H (2007) Management of large cystic adnexal tumor by gasless laparoscopic-assisted surgery with wound retractor. J Minim Invasive Gynecol 14(5):644–650

    Article  Google Scholar 

  16. Takeda A, Imoto S, Nakamura H (2014) Management of pediatric and adolescent adnexal masses by gasless laparoendoscopic single-site surgery. Eur J Obstet Gynecol Reprod Biol 181:66–71

    Article  Google Scholar 

  17. Li SH, Deng J, Huang FT, Gan XW, Cao YG (2014) Impact of gasless laparoscopy on circulation, respiration, stress response, and other complications in gynecological geriatrics. Int J Clin Exp Med 7(9):2877–2882

    PubMed  PubMed Central  Google Scholar 

  18. Bajwa SJ, Kulshrestha A (2016) Anaesthesia for laparoscopic surgery: general vs regional anaesthesia. J Minim Access Surg 12(1):4–9

    Article  Google Scholar 

  19. Akira S, Ichikawa M, Iwasaki N, Ouchi N, Mine K, Miura A et al (2011) Gasless laparoscopically assisted myomectomy using a wound retraction system. Asian J Endosc Surg 4(3):133–137

    Article  CAS  Google Scholar 

  20. Takeda A, Sakai K, Mitsui T, Nakamura H (2007) Wound retraction system for gasless laparoscopic-assisted myomectomy with a subcutaneous abdominal wall-lift method. J Minim Invasive Gynecol 14(2):240–246

    Article  Google Scholar 

  21. Sesti F, Melgrati L, Damiani A, Piccione E (2006) Isobaric (gasless) laparoscopic uterine myomectomy. An overview. Eur J Obstet Gynecol Reprod Biol. 129(1):9–14

    Article  Google Scholar 

  22. Takeda A, Imoto S, Mori M, Nakano T, Nakamura H (2010) Isobaric laparoendoscopic single-site assisted extracorporeal cystectomy in treatment of selected adnexal tumors: initial experience and technique. J Minim Invasive Gynecol 17(6):766–770

    Article  Google Scholar 

  23. Takeda A, Imoto S, Mori M, Nakano T, Nakamura H (2011) Isobaric laparoendoscopic single-site surgery with wound retractor for adnexal tumors: a single center experience with the initial 100 cases. Eur J Obstet Gynecol Reprod Biol 157(2):190–196

    Article  Google Scholar 

  24. Sesti F, Pietropolli A, Sesti FF, Piccione E (2013) Gasless laparoscopic surgery during pregnancy: evaluation of its role and usefulness. Eur J Obstet Gynecol Reprod Biol 170(1):8–12

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Simgokro 100 gil 25 Seo-gu, Incheon, 22711, South Korea

    Jong Ha Hwang, Soo Rim Kim, Jang Heub Kim & Bo Wook Kim

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  1. Jong Ha Hwang
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  2. Soo Rim Kim
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Correspondence to Bo Wook Kim.

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Jong Ha Hwang, Soo Rim Kim, Jang Heub Kim, and Bo Wook Kim have no conflicts of interest or financial ties to disclose.

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Hwang, J.H., Kim, S.R., Kim, J.H. et al. Gasless single-port access laparoscopy using a J-shaped retractor in patients undergoing adnexal surgery. Surg Endosc 35, 2457–2464 (2021). https://doi.org/10.1007/s00464-020-07654-w

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  • DOI: https://doi.org/10.1007/s00464-020-07654-w

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