D'Urbano C, Fuertes Guiro F, Sampietro R
Divisione Chirurgica 7P "P. Bucalossi", Ospedale San Carlo Borromeo, Milano.
G Chir. 1996 Mar;17(3):121-4.
The Authors present a new gasless laparoscopic cholecystectomy method using an abdominal wall elevator with subcutaneous traction ("laparotenser"). Fifty patients between May 1994 and March 1995 were operated by videolaparoscopy using this new gasless method. Twenty of them were operated with Nagai's method while the laparotenser was used in the remaining thirty. The results obtained are similar to those using pneumoperitoneum. It has been observed a global reduction of costs, less postoperative pain, no influence in cardiovascular and metabolic indexes. No complications were reported during the postoperative period but two cases of conversion to laparotomy not related to the method used were needed. Laparoscopic cholecystectomy without pneumoperitoneum using the subcutaneous elevator of the abdominal wall ("laparotenser") has demonstrated that it's possible to operate in a working space similar to that created by the pneumoperitoneum. After an initial period of distrust towards the laparoscopic methods without pneumoperitoneum it has been accepted that gasless methods multiply the indications to minimally invasive surgery in patients with cardiorespiratory problems considered no ideal candidates to laparoscopic cholecystectomy with pneumoperitoneum.
作者介绍了一种使用带皮下牵引的腹壁提升器（“laparotenser”）的新型无气腹腔镜胆囊切除术方法。1994年5月至1995年3月期间，50例患者采用这种新型无气方法进行了视频腹腔镜手术。其中20例采用长井法手术，其余30例使用laparotenser。所获得的结果与使用气腹法的结果相似。已观察到成本总体降低、术后疼痛减轻、对心血管和代谢指标无影响。术后期间未报告并发症，但有2例转为开腹手术，与所使用的方法无关。使用腹壁皮下提升器（“laparotenser”）进行无气腹腹腔镜胆囊切除术已证明，在类似于气腹所创造的工作空间中进行手术是可行的。在最初对无气腹腹腔镜方法存在不信任之后，现在已经认识到，无气方法增加了对那些被认为不是气腹腹腔镜胆囊切除术理想候选人的心肺问题患者进行微创手术的适应症。
