LAPAROSCOPIC PNEUMODISSECTION - RESULTS IN INITIAL 20 PATIENTS

BACKGROUND: The efficiency of laparoscopic procedures has been hindere d by a lack of instrumentation for blunt tissue dissection. We evaluat ed here the efficacy of a new 5-mm laparoscopic dissecting instrument, a pneumodissector. This instrument allows the surgeon to use short bu rsts of high-pressure carbon dioxide to bluntly dissect fatty tissue. STUDY DESIGN: In 20 patients undergoing a variety of laparoscopic proc edures, a 5-mm laparoscopic pneumodissector was used. Subjective asses sment of the efficacy of the instrument was recorded. In addition, aci d-base changes were measured by blood gas determination, and serum che mistries were obtained before, during, and after the procedure. RESULT S: The pneumodissector enhanced dissection of the kidney, ureter, and major blood vessels and shortened the operative time for laparoscopic nephrectomy. Although statistically significant changes in acid-base v alues occurred with use of the pneumodissector, these changes were not clinically significant and were no different than what is normally se en during carbon dioxide pneumoperitoneum. CONCLUSIONS: Laparoscopic p neumodissection is a safe and efficacious technique for rapid blunt ti ssue dissection.