Abstract
Carbon dioxide pneumoperitoneum, although used universally in laparoscopy, has several well-documented complications and disadvantages. The authors describe a simple method of creating vacuum between a rigid shell and the abdominal wall in a porcine model to create adequate operative space for minimal-access surgery, which does not requires carbon dioxide, does not raise intraabdominal pressure, and is safe, cost effective, and feasible. The proposed device and method could be useful wherever basic laparoscopic equipment and a vacuum pump are available, including many parts of the developing world. The study was carried out with three groups using individual porcine models for each study. Group 1 was studied for feasibility of abdominal wall lift, adequacy of intraabdominal space, optimal vacuum levels, and safety and efficacy of the procedure. Group 2 was subjected to laparoscopic cholecystectomy and salpingectomy. Group 3 was studied for 2 days and 8 days after the animals were subjected to prolonged, high-level vacuum and monitored every 24 h to establish long-term effects. In all three groups the safety and efficacy of the proposed method were established, as well as the absence of physiological or histological alterations.
Similar content being viewed by others
References
Alijani A, Cuschieri A (2001) Abdominal wall lift system laparoscopic surgery: gasless and low pressure systems. Semin Laparosc Surg 8: 53–62
M Bezzi V Urbano R Lorusso G Leonetti N Martone V Papaspiropoulos L Angelini (2002) ArticleTitleUse of abdominal wall retractor LaparoTenser in gasless laparoscopic cholecystectomy Ann Ital Chir 73 143–147 Occurrence Handle12197287
A Corrado M Gorini (2002) ArticleTitleNegative-pressure ventilation: is there still a role? Eur Respir J 20 187–197 Occurrence Handle10.1183/09031936.02.00302602 Occurrence Handle12166569
Smith, CR, Hamlin, RL (1993) "Regulation of heart and blood vessels." In: Swenson, MJ (ed.) Duke's physiology of cosmetic animals , 9th ed., pp 102–120
PR Edwards P Howard (1993) ArticleTitleMethods and prognosis of noninvasive ventilation in neuromuscular disease Monaldi Arch Chest Dis. 48 176–182 Occurrence Handle8518782
B Fredman R Jedeikin D Olsfanger P Flor A Gruzman (1994) ArticleTitleResidual pneumoperitoneum: a cause of postoperative pain after laparoscopic cholecystectomy Anesth Analg 79 152–154 Occurrence Handle8010427
G Galizia G Prizio E Lieto P Castellano L Pelosio V Imperatore A Ferrara A Pignatelli (2001) ArticleTitleHemodynamic and puhnonary changes during open, carbon dioxide pneumoperitoneum, and abdominal wall-lifting cholecystectomy: a prospective, randomized study Surg Endosc 15 477–483 Occurrence Handle10.1007/s004640000343 Occurrence Handle11353965
G Giraudo R Brachet Contul M Caccetta M Morino (2001) ArticleTitleGasless laparoscopy could avoid alterations in hepatic function Surg Endosc 15 741–746 Occurrence Handle10.1007/s004640090020 Occurrence Handle11591981
IH Hirsch JG Moreno MA Lotfi LG Gomella (1995) ArticleTitleNoninsufflative laparoscopic access J Endourol 9 483–486 Occurrence Handle8775080
AM Koivusalo I Kellokumpu L Lindgren (1996) ArticleTitleGasless laparoscopic cholecystectomy: comparison of postoperative recovery with conventional technique Br J Anaesth 77 576–580 Occurrence Handle8957970
A Korkmaz M Alkis O Hamamci H Besim N Erverdi (2002) ArticleTitleHemodynamic changes during gaseous and gasless laparoscopic cholecystectomy Surg Today 32 685–689 Occurrence Handle10.1007/s005950200127 Occurrence Handle12181717
A Nanashima H Yamaguchi T Tsuji E Yamaguchi T Sawai T Yasutake T Nakagoe H Ayabe (1998) ArticleTitlePhysiologic stress responses to laparoscopic cholecystectomy: a comparison of gasless and pneumoperitoneal procedures Surg Endosc Dec 12 1381–1385 Occurrence Handle10.1007/s004649900863
AG Nande SV Shrikhande V Rathod K Adyanthaya VN Shrikhande (2002) ArticleTitleModified technique of gasless laparoscopic cholecystectomy in a developing country: a 5-year experience Dig Surg 19 366–371, discussion 332 Occurrence Handle10.1159/000065836 Occurrence Handle12435907
Tenny, SM (1993) Respiration in mammals. In Swenson NJ, Reese WO (eds) Duke's physiology of domestic animals, 9th ed., pp 175–202
HJ Sugerman WI Felton SuffixIII A Sismansis BH Saggi JM Doty C Blocher A Marumarou RG Makhoul (2001) ArticleTitleContinuous negative abdominal pressure device to treat pseudotumor cerebri Int J Obese Relate Metal Discord 25 486–490 Occurrence Handle10.1038/sj.ijo.0801519
Acknowledgments
Vacuum assist abdominal wall lifting device (Vacuum shell or Vacuum Device) i.e. Abdome™, Air Ingress Trocar, its related accessories and their method of use are either patented or patent pending technologies of Ethicon Endo-Surgery Inc, Ohio, USA, a Johnson & Johnson company
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Udwadia, T.E., Kathrani, B.K., Bernie, W. et al. Vacuum-assisted abdominal wall lift for minimal-access surgery: a porcine model study. Surg Endosc 19, 1113–1119 (2005). https://doi.org/10.1007/s00464-004-2131-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-004-2131-5