Ak. Chin et al., MECHANICAL PERITONEAL RETRACTION AS A REPLACEMENT FOR CARBON-DIOXIDE PNEUMOPERITONEUM, The Journal of the American Association of Gynecologic Laparoscopists, 1(1), 1993, pp. 62-66
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.