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Laparoscopic colorectal surgery using low-pressure pneumoperitoneum combined with abdominal wall lift by placement of anchoring sutures around the camera port

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Abstract

Background

This study aimed to evaluate the feasibility of low-pressure pneumoperitoneum in laparoscopic colorectal surgery.

Methods

The authors designed low-pressure (8 mmHg) laparoscopy combined with abdominal wall lift simply by placement of anchoring sutures around the camera port.

Results

The operative indications were 176 colon cancers, 297 rectal cancers, and 45 benign diseases. The average blood loss was 92 ml (range, 20–1200 ml), and the mean operating time was 204 min (range, 23–525 min). Conversion to an open procedure was required in eight cases (1.5%). Two patients experienced intraoperative complications. The mean number of removed lymph nodes was 28.9 in the colon cancer cases and 23.1 in the rectal cancer cases. The mean length of resected specimen was 27.3 cm (range, 8.5–136 cm). Postoperatively, cardiopulmonary complications developed in five patients (0.9%).

Conclusions

Abdominal wall lifting by anchoring sutures around the camera port in addition to low-pressure pneumoperitoneum is a simple, safe, and effective method for laparoscopic colorectal procedure.

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References

  1. Abraham NS, Young JM, Solomon MJ (2004) Meta-analysis of short-term outcomes after laparoscopic resection for colorectal cancer. Br J Surg 91: 1111–1124

    Article  PubMed  CAS  Google Scholar 

  2. Alijani A, Cuschieri A (2001) Abdominal wall-lift systems in laparoscopic surgery: gasless and low-pressure systems. Semin Laparosc Surg 8: 53–62

    Article  PubMed  CAS  Google Scholar 

  3. Braga M, Vignali A, Zuliani W, Radaelli G, Gianotti L, Martani C, Toussoun G, Di Carlo V (2002) Metabolic and functional results after laparoscopic colorectal surgery: a randomized, controlled trial. Dis Colon Rectum 45: 1070–1077

    Article  PubMed  Google Scholar 

  4. Dexter SP, Vucevic M, Gibson J, McMahon MJ (1999) Hemodynamic consequence of high- and low-pressure capnoperitoneum during laparoscopic cholecystectomy. Surg Endosc 13: 376–381

    Article  PubMed  CAS  Google Scholar 

  5. Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AMH, Heath RM, Brown JM, for the MRC CLASICC trial group (2005) Short-term end points of conventional versus laparosopic-assisted surgery in patients with colorectal cancer (MRC CLASSIC trial): multicentre, randomized controlled trial. Lancet 365: 1718–1726

    Article  PubMed  Google Scholar 

  6. Horvath KD, Whelan RL, Lier B, Viscomi S, Barry L, Buck K, Bessler M (1998) The effects of elevated intraabdominal pressure, hypercarbia, and positioning on the hemodynamic responses to laparoscopic colectomy in pigs. Surg Endosc 12: 107–114

    Article  PubMed  CAS  Google Scholar 

  7. Larsen JF, Svendsen FM, Pedersen V (2004) Randomized clinical trial of the effect of pneumoperitoenum on cardiac function and haemodynamics during laparoscopic cholecystectomy. Br J Surg 91: 848–854

    Article  PubMed  CAS  Google Scholar 

  8. Leroy J, Jamali F, Forbes L, Smith M, Rubino F, Mutter D, Marescaux J (2004) Laparoscopic total mesorectal excision for rectal cancer surgery: long-term outcomes. Surg Endosc 18: 281–289

    Article  PubMed  CAS  Google Scholar 

  9. Leung KL, Kwok SP, Lam SC, Lee JF, Yiu RY, Ng SS, Lai PB, Lau WY (2004) Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trial. Lancet 363: 1187–1192

    Article  PubMed  Google Scholar 

  10. Leung KL, Yiu RY, Lai PB, Lee JF, Thung KH, Lau WY (1999) Laparoscopic-assisted resection of colorectal carcinoma: five-year audit. Dis Colon Rectum 42: 327–332

    Article  PubMed  CAS  Google Scholar 

  11. London ET, Ho HS, Neuhaus AM, Wolfe BM, Rudich SM, Perez RV (2000) Effect of intravascular volume expansion on renal function during prolonged CO2 pneumoperitoneum. Ann Surg 231: 195–201

    Article  PubMed  CAS  Google Scholar 

  12. Neudecker J, Sauerland S, Neugebauer E, Bergamaschi R, Bonjer HJ, Cuschieri A, Fuchs KH, Jacobi Ch, Jansen FW, Koivusalo AM, Lacy A, McMahon MJ, Millat B, Schwenk W (2002) The European Association for Endoscopic Surgery clinical practice guideline on the pneumoperitoneum for laparoscopic surgery. Surg Endosc 16: 1121–1143

    Article  PubMed  CAS  Google Scholar 

  13. Rauh R, Hemmerling TM, Rist M, Jacobi KE (2001) Influence of pneumoperitoneum and patient positioning on respiratory system compliance. J Clin Anesth 13: 361–365

    Article  PubMed  CAS  Google Scholar 

  14. The Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350: 2050–2059

    Article  Google Scholar 

  15. The Colon Cancer Laparoscopic or Open Resection Study Group (2005) Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol 6: 477–484

    Article  PubMed  Google Scholar 

  16. Wallace DH, Serpell MG, Baxter JN, O’Dwyer PJ (1997) Randomized trial of different inflation pressures for laparoscopic cholecystectomy. Br J Surg 84: 455–458

    Article  PubMed  CAS  Google Scholar 

  17. WHO (1997) Obesity: preventing and managing the global epidemic. WHO Technical Report Series, No. 894. World Health Organization, Geneva

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Acknowledgment

This work was supported by the DongGuk University Research Fund.

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Correspondence to S. H. Kim.

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Park, I.J., Kim, S.H., Joh, Y.G. et al. Laparoscopic colorectal surgery using low-pressure pneumoperitoneum combined with abdominal wall lift by placement of anchoring sutures around the camera port. Surg Endosc 20, 956–959 (2006). https://doi.org/10.1007/s00464-005-0459-0

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  • DOI: https://doi.org/10.1007/s00464-005-0459-0

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