INSTRUMENTS FOR GASLESS LAPAROSCOPIC SURGERY

In addition to physiological consequences of the pneumoperitoneum, the re are many technical disadvantages. Specially designed instruments fo r laparoscopic procedures using CO2 gas insufflation and valved trocar s with small diameters are expensive, delicate and often single-use it ems. Besides restricting the surgeon's freedom of movement they lead t o a lack of tactile sense and their handling requires a lot more pract ise compared to conventional instruments. For gasless laparoscopy we u se a planar lift system (Origin(TM)), to attain a sufficient extension to the abdominal wall. The gasless technique allows the use of every laparoscopic instrument without exception, which originally was design ed for a pneumoperitoneum. In addition conventional instruments, used in open surgery, can be employed with simple valveless trocars. Instru ments without any comparable laparoscopic equivalent can be used. The disadvantage in using instruments designed for conventional surgery is that in their development ergonomic criteria for a laparoscopic appli cation have not been considered. We developed a special instrument set where instrument length, shape and joint position have been designed to fit the needs of gasless laparoscopy. The combination of laparoscop ic and ergonomically adapted conventional instruments may lead to prog ress in the technique of laparoscopic surgery.