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Comparison of a new gasless method and the conventional CO₂ pneumoperitoneum method in laparoendoscopic single-site cholecystectomy: a prospective randomized clinical trial.

ABSTRACT: To avoid CO₂ pneumoperitoneum-associated cardiopulmonary side-effects during conventional laparoscopic surgeries, we have developed a gasless laparoscopic operation field formation (LOFF) device for laparoendoscopic single-site surgery. The aim of this study is to analyze the safety and efficacy of the LOFF device for laparoendoscopic single-site cholecystectomy and to verify its advantage of avoiding CO₂ pneumoperitoneum-associated complications. In this prospective, randomized, observer-blinded clinical trial, eligible participants were randomized in a 1:1 ratio to undergo either conventional CO₂ pneumoperitoneum assisted laparoendoscopic single-site cholecystectomy (LESS) or the new gasless LOFF device assisted laparoendoscopic single-site cholecystectomy (LOFF-LESS). Outcomes including intra-operative respiratory and hemodynamic parameters, operation time, conversion rate, complication rate, et al were compared between the two groups. A total of 100 patients were randomized to the LESS group [n = 50; mean (SD) age, 49.5 (13.9) years; 24 (48.0%) women] and the LOFF-LESS group [n = 50, mean (SD) age, 47.4 (13.3) years; 27 (54.0%) women]. Compared with the LOFF-LESS group, the LESS group witnessed significant fluctuations in intra-operative respiratory and hemodynamic parameters. The tracheal extubation time of the LESS group was significantly longer (P = 0.001). The gasless LOFF device is safe and feasible for simple laparoscopic cholecystectomy and has a predominance of avoiding CO₂ pneumoperitoneum-associated cardiopulmonary side-effects. Trial registration number: ChiCTR2000033702.

SUBMITTER: Jiang M

PROVIDER: S-EPMC8606390 | biostudies-literature |

REPOSITORIES: biostudies-literature

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A different technique in gasless, laparoendoscopic, single-site myomectomy.

Project description:BackgroundThe aim of this study was to introduce a novel technique for gasless, laparoendoscopic, single-site (GLESS) myomectomy and to evaluate its feasibility and safety.MethodsA retrospective observational study was performed at a hospital from Sep 2017 to Nov 2018. 15 patients with symptomatic subserosal or intramural myomas underwent GLESS myomectomy.ResultsThe mean age and body mass index were 41.73 ± 8.58 years and 22.72 ± 2.27 kg/m2, respectively. 5 patients had a history of abdominal surgery, including four caesarean deliveries and one myomectomy. The mean operative duration, blood loss volume, time to specimen removal, time of bowel activity and postoperative hospitalization duration were 156.47 ± 62.19 min, 57.33 ± 72.35 ml, 29.87 ± 13.6 min, 27.67 ± 10.06 h, and 3.4 ± 0.74 days, respectively. The operation was successful in all patients, there were no surgical or wound complications in any patient, and the histopathological result was leiomyoma in all 15 patients.ConclusionThe procedure is feasible and safe in selected patients with symptomatic myomas.

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Prospective randomized controlled trial on comparison of standard CO<sub>2</sub> pressure pneumoperitoneum insufflator versus AirSeal®.

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Experimental use of a novel single-port gasless laparoendoscopic operative field formation device.

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Laparoendoscopic single-site surgery compared with conventional laparoscopic surgery for benign ovarian masses: a systematic review and meta-analysis.

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Laparoendoscopic single-site adrenalectomy versus multi-port laparoendoscopic adrenalectomy: A systemic review and meta-analysis.

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Ergonomic learning curves on gynecological laparoendoscopic single-site (LESS) surgery.

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