Instruments for gasless laparoscopic surgery

In addition to physiological consequences of the pneumoperitoneum, there are many technical disadvantages. Specially designed instruments for laparoscopic procedures using CO2 gas insufflation and valved trocars with small diameters are expensive, delicate and often single-use items. Besides restricting the surgeon's freedom of movement they lead to a lack of tactile sense and their handling requires a lot more practise compared to conventional instruments. For gasless laparoscopy we use a planar lift system (Origin(TM)), to attain a sufficient extension to the abdominal wall. The gasless technique allows the use of every laparoscopic instrument without exception, which originally was designed for a pneumoperitoneum. In addition conventional instruments, used in open surgery, can be employed with simple valveless trocars. Instruments without any comparable laparoscopic equivalent can be used. The disadvantage in using instruments designed for conventional surgery is that in their development ergonomic criteria for a laparoscopic application have not been considered. We developed a special instrument set where instrument length, shape and joint position have been designed to fit the needs of gasless laparoscopy. The combination of laparoscopic and ergonomically adapted conventional instruments may lead to progress in the technique of laparoscopic surgery.