title: The new techniques of gynaecologic laparoscopy. Gasless, open Hasson, optic trocar.
abstract: BACKGROUND
  New techniques of laparoscopy: gasless, open Hasson, optic trocars allow to avoid the risks of vessel and bowel injuries. The objective of this study was to evaluate the capability of a retractor system as an alternative to conventional technique without pneumoperitoneum and to assess if the system facilitates the use of conventional surgical instruments during gynaecological surgery.
  
  
  METHODS
  
  
  
  METHODS
  Prospective evaluation.
  
  
  METHODS
  University-affiliated county hospital.
  
  
  METHODS
  Gasless laparoscopy surgery was performed on 49 patients between December 1995 and July 1996 with a retractor system without pneumoperitoneum consisting of an intrabdominal retractor using conventional surgical and laparoscopic instruments and to enable a simultaneous vaginal approach.
  
  
  RESULTS
  Gasless laparoscopy was successful in 44 (90%) of cases. A simultaneous vaginal approach was used in one third of indications including vaginal myomectomy and laparoscopic assisted hysterectomy. Conversion to laparotomy was required in 5% of cases. Mean procedure duration was 90 minutes and mean hospitalisation time was 5.7 days.
  
  
  CONCLUSIONS
  The introduction of new techniques of laparoscopy: gasless, open Hasson, optic trocars has broadened the application of operative laparoscopy. Gasless technique in lieu of conventional laparoscopy can be performed reliably and safely for most gynaecological indications. The most outstanding benefit of this method is that it can be combined with a vaginal approach which is not possible using a pneumoperitoneum due to gas leakage. The place of gasless laparoscopy will depend on continuing development by instrument manufacturers, in order to achieve an instrument providing vision as good as that seen with the pneumoperitoneum.
authors.affiliation: Department of Obstetrics and Gynaecology, E. Agnelli Hospital of Pinerolo, Torino, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Canestrelli
authors.forename: M
authors.initials: M
authors.lastname: Cannì
authors.forename: R
authors.initials: R
authors.lastname: Mori
authors.forename: B
authors.initials: B
authors.lastname: Blanc
authors.forename: P
authors.initials: P
authors.lastname: Trompeo
mesh_terms: D005260:Female; D005336:Fiber Optic Technology / Q000295:instrumentation; D005740:Gases; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D011028:Pneumoperitoneum, Artificial
chemical_list: D005740:Gases