Can spiral-shaped abdominal wall lift replace pneumoperitoneum in laparoscopic cholecystectomy? A randomised study

Abstract

Background: A new design of abdominal lift system for gasless laparoscopy has been introduced in rural areas. Aims and Objectives: To assess whether the new spiral design abdominal wall lift system has similar outcomes to standard pneumoperitoneum laparoscopic cholecystectomy. Materials and Methods: Sixty cases of symptomatic gallstone disease scheduled for laparoscopic cholecystectomy were randomly assigned to gasless spiral abdominal wall lift or to standard pressure pneumoperitoneum, followed by cholecystectomy. Post-operative abdominal and shoulder tip pain, duration and ease of surgery and surgical site complications were compared. Results: There was a significant difference in post-operative abdominal pain at 24 hours after surgery (P < 0.01). Shoulder tip pain was lower at 6 h (P < 0.01). The duration of surgery was comparable in both groups; the time taken decreased in the abdominal lift procedure with increasing experience. Conversion rate and surgical site complications were similar. There were comparable outcomes in terms of overall post-operative abdominal pain; shoulder tip pain; duration of surgery; conversions and post-operative complications between the two groups. Ease of surgery improved with number of cases over time. Conclusion: Abdominal lift may be a valid alternative to pneumoperitoneum cholecystectomy with comparable outcomes in resource constrained areas.

Keywords

• abdominal wall lift device
• cholecystectomy
• gasless laparoscopy
• pneumoperitoneum