REMOVAL OF BULKY TISSUE AT LAPAROSCOPIC SURGERY

A technique for extraction of bulky tissue during laparoscopic surgery is presented. One laparoscopic cannula is replaced with a sigmoidosco pe which acts as a wide-bore cannula. At laparoscopic cholecystectomy, 22 of 60 (38%) patients were found to require wound enlargement to re move a grossly diseased gall-bladder. Use of a sigmoidoscope as a cann ula was associated with fewer technical complications than surgical wo und extension. At laparoscopic appendicectomy, the appendix could not be removed through the standard laparoscopic cannula in 16 of 46 (31%) cases. The incidence of wound infection was significantly lower after laparoscopic appendicectomy than among a group of 98 patients having conventional appendicectomy (P = 0.024). It is concluded that a sigmoi doscope can be used as a replacement cannula allowing uncomplicated re moval of bulky tissue and reducing wound contamination.