Comparative Study Of Gasless Laparoscopic Cholecystectomy Using Umbrella-like Abdominal Wall-lifting Device Versus Pneumoperitoneum In Animal Experiments

Background:The CO2pneumoperitoneum technique has been used to establish an operationspace in laparoscopic surgery. However, CO2pneumoperitoneum may have somebad consequences, such as respiratory and circulatory system changes and therelease of free tumor cells into abdominal cavity. Gasless laparoscopic techniquecan avoid these adverse effects of CO2pneumoperitoneum to the human body.These advantages have important clinical significance for elderly patients,patients with heart and lung dysfunction, pregnant patients, and patients whoundergo long operations. However, a flaw in forthcoming gasless techniques is aninadequate operation space. To overcome this disadvantage, we have developedan umbrella-like abdominal-wall-lifting device which can provide sufficientoperation space.Objective:To explore the feasibility and safety and effection of Umbrella-Like Abdominal Wall-Lifting Device in gasless laparoscopic surgery in animal experiment. Andsumming up the advantage and disadvantage of the device.Materials and Methods:Twenty one Bana experiment pigs who were provided by the animal sciencedepartment of Guangxi university, these were randomly divided into two groupsaccording with the approach of establishing operation space, all pigs werereceived laparoscopic cholecystectomy：One group was treated with gaslesstechnique using umbrella-like abdominal wall-lifting device(umbrella group).Another group underwent pneumoperitoneum (gas group). The parameters werecompared, including time of establishing operation space, time of gallbladderremoval, bleeding volume and the unexpected occurrences during the operationbetween two groups.Results:For umbrella group, n=10case, and n=11case for gas group. There was nosignificant difference in gender, age and body weight of pigs. the two groupswere comparable. All the surgeries were completed successfully withoutconversion to open procedure in two groups. The time of establishing operationspace was no difference between two groups (t=1.979, p=0.059). No significantdifference was found in the time of gallbladder removal (t=0.096, p=0.924) andblood loss (t=0.016, p=0.988) between two groups. The greater omentum gotstuck on the spokes during the process of opening the umbrella in two cases ofumbrella group, there were no complications of massive hemorrhage and internal organ injury during the operations.Conclusions:(1)These exeperiments outcomes indicates that the Umbrella-Like AbdominalWall Lifting Device is feasible, effective and safe in gasless laparoscopiccholecystectomy.(2)The Umbrella-Like Abdominal Wall Lifting Device can meet the operationspace exposure, but also exsitting the disadvantage of injuring abdominal wall.