Laparoscopic surgery in gynecology: randomized prospective study comparing pneumoperitoneum and abdominal wall suspension.
OBJECTIVE
To compare laparoscopic surgery using insufflation of carbon dioxide gas with laparoscopic surgery using abdominal wall retractor in gynecology.


METHODS
University hospital.


METHODS
Prospective randomized study.


METHODS
Fifty-one patients were assigned to the gasless laparoscopy group, and 52 patients were assigned to the laparoscopy group with pneumoperitoneum. Patients presented with ovarian cyst, endometriosis, acute salpingitis, hydrosalpinx and extra-uterine pregnancy.


RESULTS
No severe complications were noted. One conversion to laparotomy was performed in each group. Eight gasless laparoscopic procedures were converted into laparoscopy with pneumoperitoneum; difficulties appeared in patients with adhesions following laparotomy and in cases of unsatisfactory exposure of the pelvis. No differences appeared between the two groups in terms of complications, quality of the operative sequelae, and duration of hospitalization.


CONCLUSIONS
Gasless surgery is a recent technique and progress in modifying the equipment is necessary to reduce conversions.
Cravello
L
L
Obstetrics and Gynecology Department B, Hôpital de la Conception, Marseille, France.
D'Ercole
C
C
Roger
V
V
Samson
D
D
Blanc
B
B
D000009:Abdominal Muscles; D000328:Adult; D002245:Carbon Dioxide; D005260:Female; D005831:Genital Diseases, Female / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy; D007902:Length of Stay; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects; D011183:Postoperative Complications; D011446:Prospective Studies; D013525:Surgical Instruments
D002245:Carbon Dioxide