MECHANICAL PERITONEAL RETRACTION AS A REPLACEMENT FOR CARBON-DIOXIDE PNEUMOPERITONEUM

A fan retractor and a mechanical lifting arm were developed to achieve planar displacement of the anterior abdominal wall for gasless laparo scopic procedures. The technique permits the use of conventional open surgical instruments as well as laparoscopic tools through minilaparot omy incisions. It also potentially addresses the technical constraints imposed by pneumoperitoneum, and physiologic concerns regarding carbo n dioxide insufflation. Gynecologic, general surgical, and trauma proc edures were performed in 104 patients, with successful completion of 8 6.5%. Continued application is necessary to delineate the full range o f benefits of laparoscopy without insufflation.