Laparoscopic pneumodissection: results in initial 20 patients.
BACKGROUND
The efficiency of laparoscopic procedures has been hindered by a lack of instrumentation for blunt tissue dissection. We evaluated here the efficacy of a new 5-mm laparoscopic dissecting instrument, a pneumodissector. This instrument allows the surgeon to use short bursts of high-pressure carbon dioxide to bluntly dissect fatty tissue.


METHODS
In 20 patients undergoing a variety of laparoscopic procedures, a 5-mm laparoscopic pneumodissector was used. Subjective assessment of the efficacy of the instrument was recorded. In addition, acid-base changes were measured by blood gas determination, and serum chemistries were obtained before, during, and after the procedure.


RESULTS
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 acidbase values occurred with use of the pneumodissector, these changes were not clinically significant and were no different than what is normally seen during carbon dioxide pneumoperitoneum.


CONCLUSIONS
Laparoscopic pneumodissection is a safe and efficacious technique for rapid blunt tissue dissection.
Pearle
M S
MS
Department of Urology, University of Texas, Southwestern Medical Center, Dallas 75235-9110, USA.
Nakada
S Y
SY
McDougall
E M
EM
Monk
T G
TG
Pingleton
E
E
Roemer
F D
FD
Clayman
R V
RV
D000136:Acid-Base Equilibrium; D004210:Dissection / Q000295:instrumentation*; D006801:Humans; D007327:Insufflation / Q000295:instrumentation*; D020706:Laparoscopes; D008197:Lymph Node Excision / Q000295:instrumentation; D009392:Nephrectomy / Q000295:instrumentation / Q000379:methods