GASLESS LAPAROSCOPY - USELESS OR USEFUL

Carbon dioxide (CO2) pneumoperitoneum for advanced operative laparosco py has well-documented inherent pathophysiologic risks. Problems are a ssociated with creating and maintaining the pneumoperitoneum, lowering body temperature, infective particles in the insufflation gas, and en suring hemostasis of port entry sites after intraabdominal pressure is reduced. When the vagina is opened to remove surgical specimens or at the time of hysterectomy, loss of vision occurs. In some patient gene ral anesthesia and CO2 pneumoperitoneum are contraindicated, and in th em such problems could be avoided by gasless laparoscopy. Three types of mechanical anterior abdominal wall elevators have been used at the Melbourne Gynoscopy Centre for a variety of laparoscopic procedures, a ll of which have their advantages and disadvantages.