A MODIFIED HOME-MADE ABDOMINAL WALL LIFT DEVICE FOR GASLESS LAPAROSCOPIC CHOLECYSTECTOMY

Introduction: The rationale of gasless laparoscopy using abdominal wall lifting (AWL) is to avoid the deleterious effects of carbon dioxide pneumo-peritoneum particularly in patients with cardiopulmonary diseases. Despite that, the AWL apparatus has not gained worldwide popularity, most probably due to its cost, complexity or unavailability. The aim of this work was to assess the feasibility of a simple modified gasless technique in laparoscopic cholecystectomy using a homemade set. Materials and Methods: This prospective study included 20 cases with chronic calcidar cholecystitis with a mean weight of 65.77 Kg (45 - 101). Conventional Foley s catheters (F16-F24) were used for AWL. Traction of these catheters was maintained manually or using the simple home-made mechanical retractor described in this study. Results: Laparoscopic cholecystectomy was carried out successfully in 15 patients (75%) using this new technique. Failure was found in over weight patients and those with marked adhesions. No mortality but technique-related morbidity was minimal (early abdominal wall pain at the trocar site with late visible scars). No common bile duct or visceral injury ivas recorded. Conclusion: This technique provided a simple, cheap, safe, and easily available home-made total AWL device particularly in non obese patients