Zúñiga HA, Gallegos SVA, Díaz SJA, Flores ÁE, García MM, Castañeda RF, Caldera SVU

Language: Spanish
References: 22
Page: 68-72
PDF size: 258.08 Kb.

ABSTRACT

Introduction: Laparoscopic surgery has been one of the major surgical advances. Currently the most popular technique advocates the use of insufflated hyperbaric neumoperitoneum. However the increased intraabdominal pressure may cause some undesired cardiovascular and respiratory effects. Lifting the abdominal wall with a mechanical retractor may prevent this problem while providing the necessary space to operate laparoscopically. The purpose of our study was to demonstrate the feasibility and safety of a semiloop shaped retractor and it’s restraint system in performing laparoscopic cholecystectomy under isobaric pneumoperitoneum. Material and methods: We used the abdominal wall retractor to perform elective laparoscopic cholecystectomy in patients diagnosed with cholecystitis. Our endpoints were surgical time, retractor installation time, surgical blood loss, postoperative pain and complications. Results: We operated 15 patients, median age 26, median BMI 25. Mean operative time 64 min, mean installation time of the retraction device 8 min, mean intraoperative blood loss 57 mL, postoperative pain (visual analogue scale) was 0-1 in 3 patients, 2-3 in 8, and 4 in 4 patients. During the procedures we had 5 minor incidents (3 omental entrapments by the retractor and 2 port-site bleedings) all resolved transoperatively. Discussion: The use of this retractor allowed us all the required views and maneuvers to perform laparoscopic cholecystectomy without altering any cardiopulmonary parameters in our patients and had similar outcomes as those reported for conventional laparoscopic cholecystectomy. Conclusions: From this preliminary experience we conclude that the use of the semi-loop shaped retractor is feasible and safe. It’s use may help in preventing cardiopulmonary alterations associated to hyperbaric neumoperitoneum.

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