Full Text:   <1748>

CLC number: R71

On-line Access: 

Received: 2008-04-11

Revision Accepted: 2009-09-23

Crosschecked: 2009-09-25

Cited: 4

Clicked: 3352

Citations:  Bibtex RefMan EndNote GB/T7714

-   Go to

Article info.
1. Reference List
Open peer comments

Journal of Zhejiang University SCIENCE B 2009 Vol.10 No.11 P.805~812


Gasless laparoscopy for benign gynecological diseases using an abdominal wall-lifting system

Author(s):  Yue WANG, Heng CUI, Yan ZHAO, Zhi-qi WANG

Affiliation(s):  Department of Obstetrics and Gynecology, Peking University People’ more

Corresponding email(s):   cuiheng20@163.com

Key Words:  Gasless laparoscopy, Pneumoperitoneum laparoscopy, Ovarian cyst resection

Yue WANG, Heng CUI, Yan ZHAO, Zhi-qi WANG. Gasless laparoscopy for benign gynecological diseases using an abdominal wall-lifting system[J]. Journal of Zhejiang University Science B, 2009, 10(11): 805~812.

@article{title="Gasless laparoscopy for benign gynecological diseases using an abdominal wall-lifting system",
author="Yue WANG, Heng CUI, Yan ZHAO, Zhi-qi WANG",
journal="Journal of Zhejiang University Science B",
publisher="Zhejiang University Press & Springer",

%0 Journal Article
%T Gasless laparoscopy for benign gynecological diseases using an abdominal wall-lifting system
%A Heng CUI
%A Zhi-qi WANG
%J Journal of Zhejiang University SCIENCE B
%V 10
%N 11
%P 805~812
%@ 1673-1581
%D 2009
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B0820122

T1 - Gasless laparoscopy for benign gynecological diseases using an abdominal wall-lifting system
A1 - Yue WANG
A1 - Heng CUI
A1 - Yan ZHAO
A1 - Zhi-qi WANG
J0 - Journal of Zhejiang University Science B
VL - 10
IS - 11
SP - 805
EP - 812
%@ 1673-1581
Y1 - 2009
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B0820122

Objectives: The use of gasless laparoscopy with an abdominal wall-lifting device for benign gynecological diseases was compared to conventional laparoscopy with CO2 pneumoperitoneum. Methods: From February 2007 to July 2007, 76 women with uterine and/or adnexal benign diseases and candidates for laparoscopic surgery were recruited in this study. Thirty-two women underwent gasless laparoscopic surgery and 44 women underwent pneumoperitoneum laparoscopic surgery. Results: Diverse pathologies, including adnexal cyst, uterine myoma and ectopic pregnancy, were treated successfully with gasless laparoscopic surgery. Compared with the patients in the pneumoperitoneum group, the similar hospital stay (P=0.353) and intraoperative blood loss (P=0.157) were observed. However, the mean operative time in the gasless group was significantly longer than that in the pneumoperitoneum group (P=0.003). No severe intraoperative or postoperative complications were found in either group, except for one case of laparotomic conversion in the pneumoperitoneum group due to dense pelvic adhesions. The total hospital charges were significantly less in the gasless group than in the pneumoperitoneum group (P=0.001). In 38 cases of ovarian cyst resection, the mean operative time in the gasless group remained longer than that in the pneumoperitoneum group (P=0.017). The total hospital charges were also significantly less in the gasless group than in the pneumoperitoneum group (P<0.001). Conclusion: Our preliminary results demonstrated that the laparoscopic procedure using the gasless technique was a safe, effective method to treat benign gynecological diseases. Moreover, it was easy to master. As a minimally invasive treatment, gasless laparoscopic surgery provides a good choice to patients in the undeveloped regions in China without increasing the patients’ and the government’s burden significantly.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article


[1] Alijani, A., Cuschieri, A., 2001. Abdominal wall lift systems in laparoscopic surgery: gasless and low-pressure systems. Semin. Laparosc. Surg., 8(1):53-62.

[2] Bojahr, B., Lober, R., Straube, W., Kohler, G., 1996. Gasless laparoscopic-assisted radical vaginal hysterectomy with lymphadenectomy for cervical carcinoma. J. Am. Assoc. Gynecol. Laparosc., 3(4):S4-S5.

[3] Chin, A.K., Moll, F.H., McColl, M.B., Reich, H., 1993. Mechanical peritoneal retraction as a replacement for carbon dioxide pneumoperitoneum. J. Am. Assoc. Gynecol. Laparosc., 1(1):62-66.

[4] Damiani, A., Melgrati, L., Marziali, M., Sesti, F., 2003. Gasless laparoscopic myomectomy. Indications, surgical technique and advantages of a new procedure for removing uterine leiomyomas. J. Reprod. Med., 48(10): 792-798.

[5] Damiani, A., Melgrati, L., Franzoni, G., Stepanyan, M., Bonifacio, S., Sesti, F., 2006. Isobaric gasless laparoscopic myomectomy for removal of large uterine leiomyomas. Surg. Endosc., 20(9):1406-1409.

[6] Davila, G.W., Stanford, E., Korn, A., 2004. Prospective trial of gasless laparoscopic Burch colposuspension using conventional surgical instruments. J. Am. Assoc. Gynecol. Laparosc., 11(2):197-203.

[7] Goldberg, J.M., Maurer, W.G., 1997. A randomized comparison of gasless laparoscopy and CO2 pneumoperitoneum. Obstet. Gynecol., 90(3):416-420.

[8] Guido, R.S., Brooks, K., McKenzie, R., Gruss, J., Krohn, M.A., 1998. A randomized, prospective comparison of pain after gasless laparoscopy and traditional laparoscopy. J. Am. Assoc. Gynecol. Laparosc., 5(2):149-153.

[9] Hill, D.J., Maher, P.J., Wood, E.C., 1994. Gasless laparoscopy—useless or useful? J. Am. Assoc. Gynecol. Laparosc., 1(3):265-268.

[10] Jiang, J.K., Chen, W.S., Yang, S.H., Lin, T.C., Lin, J.K., 2001. Gasless laparoscopy-assisted colorectal surgery. Surg. Endosc., 15(10):1093-1097.

[11] Johnson, P.L., Sibert, K.S., 1997. Laparoscopy. Gasless vs. CO2 pneumoperitoneum. J. Reprod. Med., 42(5):255-259.

[12] Kruschinski, D., Homburg, S., 2005. Lift-(gasless) laparoscopic surgery under regional anesthesia. Surg. Technol. Int., 14(5):193-196.

[13] Kruschinski, D., Homburg, S., Wockel, A., Kapur, A., Reich, H., 2004. Lift-laparoscopic total hysterectomy as a routine procedure. Surg. Technol. Int., 13:147-156.

[14] Larsen, J.F., Ejstrud, P., Kristensen, J.U., Svendsen, F., Redke, F., Pedersen, V., 2001. Randomized comparison of conventional and gasless laparoscopic cholecystectomy: operative technique, postoperative course, and recovery. J. Gastrointest. Surg., 5(3):330-335.

[15] Li, B., Hao, J., Gao, X., Liu, T., Zhang, J., Wang, H., Chen, Y., Wu, J., 2001. Gynecological procedures under gasless laparoscopy. Chin. Med. J. (Engl.), 114(5):514-516.

[16] Lukban, J.C., Jaeger, J., Hammond, K.C., LoBraico, D.A., Gordon, A.M., Graebe, R.A., 2000. Gasless versus conventional laparoscopy. N. J. Med., 97(5):29-34.

[17] Nakamura, H., Kobori, Y., Goseki, N., Inoue, H., Takeshita, K., Endo, M., Nakamura, T., 1996. Fishing-rod-type abdominal wall lifter for gasless laparoscopic surgery. Surg. Endosc., 10(9):944-946.

[18] Ogihara, Y., Isshiki, A., Kindscher, J.D., Goto, H., 1999. Abdominal wall lift versus carbon dioxide insufflation for laparoscopic resection of ovarian tumors. J. Clin. Anesth., 11(5):406-412.

[19] Oguri, H., Taniguchi, K., Fukaya, T., 2005. Gasless laparoscopic management of ovarian cysts during pregnancy. Int. J. Gynaecol. Obstet., 91(3):258-259.

[20] Semm, K., 1978. Tissue-puncher and loop-ligation—new aids for surgical-therapeutic pelviscopy (laparoscopy)= endoscopic intraabdominal surgery. Endoscopy, 10(2): 119-124.

[21] Semm, K., 1979. New methods of pelviscopy (gynecologic laparoscopy) for myomectomy, ovariectomy, tubectomy and adnectomy. Endoscopy, 11(2):85-93.

[22] Sesti, F., Melgrati, L., Damiani, A., Piccione, E., 2006. Isobaric (gasless) laparoscopic uterine myomectomy. An overview. Eur. J. Obstet. Gynecol. Reprod. Biol., 129(1): 9-14.

[23] Sesti, F., Capobianco, F., Capozzolo, T., Pietropolli, A., Piccione, E., 2008. Isobaric gasless laparoscopy versus minilaparotomy in uterine myomectomy: a randomized trial. Surg. Endosc., 22(4):917-923.

[24] Smith, R.S., Fry, W.R., Tsoi, E.K., Henderson, V.J., Hirvela, E.R., Koehler, R.H., Brams, D.M., Morabito, D.J., Peskin, G.W., 1993. Gasless laparoscopy and conventional instruments. The next phase of minimally invasive surgery. Arch. Surg., 128(10):1102-1107.

[25] Takeda, A., Sakai, K., Mitsui, T., Nakamura, H., 2007. Management of large cystic adnexal tumor by gasless laparoscopic-assisted surgery with wound retractor. J. Minim. Invasive Gynecol., 14(5):644-650.

[26] Tintara, H., Choobun, T., 2004. Laparoscopic adnexectomy for benign tubo-ovarian disease using abdominal wall lift: a comparison to laparotomy. Int. J. Gynaecol. Obstet., 84(2):147-155.

[27] Tintara, H., Leetanaporn, R., Getpook, C., Suntharasaj, T., 1998. Simplified abdominal wall-lifting device for gasless laparoscopy. Int. J. Gynaecol. Obstet., 61(2):165-170.

[28] Topel, H.C., 1994. Gasless laparoscopic assisted hysterectomy with epidural anesthesia. J. Am. Assoc. Gynecol. Laparosc., 1(4 Part 2):S36.

Open peer comments: Debate/Discuss/Question/Opinion


Please provide your name, email address and a comment

Journal of Zhejiang University-SCIENCE, 38 Zheda Road, Hangzhou 310027, China
Tel: +86-571-87952783; E-mail: cjzhang@zju.edu.cn
Copyright © 2000 - Journal of Zhejiang University-SCIENCE