title: Experience with a new design of endoretractor for gasless laparoscopic cholecystectomy.
abstract: BACKGROUND
  Cholecystectomy has replaced open surgery and is regarded as the standard procedure today. The pneumoperitoneum needed to create working space can induce cardiovascular changes. Gasless laparoscopic surgery is effective; we evaluate a new retractor design.
  
  
  METHODS
  Patients older than 15 years with elective cholecystectomy and American Society of Anesthesiology I-II were consequently assigned to conventional or gasless surgery. We evaluated surgical time, hemodynamic stability, hours of hospital stay, and days of recuperation.
  
  
  RESULTS
  We analyzed 22 cholecystectomies, 10 by the gasless technique and 12 by gas laparoscopy. We did not observe significant differences in surgical time, length of hospital stay, or days of recuperation. However, surgical exposition time was longer in the retractor group than was expected by chance (P<0.05). Hemodynamic stability was similar between the groups.
  
  
  CONCLUSIONS
  Similar surgical and recuperation times and length of hospital stay were observed. Our design is comparable with conventional laparoscopic surgery despite longer surgical exposition time.
authors.affiliation: División de Cirugía General, Hospital General de Zona, IMSS Instituto Mexicano del Seguro Social, Universidad Autónoma de San Luis Potosí, San Luís Potosí, México.
authors.forename: Marco A
authors.initials: MA
authors.lastname: Vázquez-Rosales
authors.forename: Jesús Martín
authors.initials: JM
authors.lastname: Sánchez-Aguilar
authors.forename: Francisco
authors.initials: F
authors.lastname: Hernández-Sierra
authors.forename: Guillermo
authors.initials: G
authors.lastname: Vázquez-Rosales
authors.forename: Peter B
authors.initials: PB
authors.lastname: Mandeville
authors.forename: Jorge Humberto
authors.initials: JH
authors.lastname: Tapia-Pérez
authors.forename: Martín
authors.initials: M
authors.lastname: Sánchez-Reyna
authors.forename: Antonio A
authors.initials: AA
authors.lastname: Gordillo-Moscoso
mesh_terms: D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation / Q000379:methods*; D041761:Cholecystolithiasis / Q000601:surgery; D004867:Equipment Design; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial