Gasless Laparoscopic Assisted Hysterectomy with Epidural Anesthesia.

Gasless laparoscopy is an evolving technique which can offer significant advantages to both patient and surgeon. A variety of major laparoscopic operations can be performed with gasless surgery including oophorectomy, myomectomy, and hysterectomy. The use of conventional instrumentation and open ports significantly improves the ease of surgery and greatly facilitates techniques such as endosuturing. For those patients with a contraindication, or a fear of general anesthesia, gasless laparoscopy under a regional anesthetic is now a reasonable alternative. A laparoscopic-assisted vaginal hysterectomy was performed with gasless technique under continuous epidural anesthesia. The surgery was completed without complication, and the patient expressed a high degree of satisfaction. Subsequently, three additional patients have successfully undergone major laparoscopic operations using a gasless technique and epidural anesthesia. With careful patient selection and attention to proper technique, gasless laparoscopy under regional anesthesia is a safe and viable alternative to conventional CO2 laparoscopy.