An Effective Way to Prevent Depressurization of Carboxyperitoneum and Extraperitoneal Insufflation During Simultaneous Laparoscopic Interventions

ABSTRACT. Laparoscopic simultaneous surgery (LSS) in patients with multisystem abdominal organs lesion is accompanied by ports’ re-installation for subsequent surgical intervention. Preserved trocar wounds (PTWs) pass carbon dioxide from the abdominal cavity, increasing its consumption and causing depressurization of the carboxyperitoneum. The incidence of extraperitoneal insufflation during laparoscopy varies from 0.43 to 2% (I.V. Vartanova et al., 2016). The presence of many methods of sealing PTWs indicates their inefficiency.

AIM OF STUDY. To develop an easy-to-use, more reliable and effective way of sealing PTWs.

RESULTS. As a result, a comparative evaluation of known methods of sealing PTWs, we have developed an easy-to-use, more reliable and effective way of sealing PTWs «Method for sealing punctures of the abdominal wall after removing the trocar during a laparoscopic surgery» (patent RF for the invention № 2621121).

DISCUSSION. This method was performed in 55 patients, in all cases it provided reliable PTWs tightness, allowed maintaining stable carboxyperitoneum during laparoscopic interventions, without increasing carbon dioxide consumption, which reduced the cost of LSS and prevented the development of both intraand postoperative complications. The uniqueness of this method is that PTW is sealed from the side of the abdominal cavity, preventing carbon dioxide from penetrating into either the preperitoneal or subcutaneous tissue.

CONCLUSION. An increase in the number of patients with combined surgical pathology necessitates the use of the developed method for sealing punctures when moving trocars and neutralizing sub- and postoperative complications. In addition, this method allows to reduce carbon dioxide consumption.

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