Office Laparoscopy

29/04/2020

Laparoscopy and COVID-19
How to perform a laparoscopic hysterectomy without carbon dioxide to avoid Aerosols of Corona Virus?

Here is a total lift-laparoscopic hysterectomy from 2009, which was more than 10 years ago.

Nowadays I still perform it the same way with the special designed bipolar clamps and scissors.

In Germany from next week we are somewhat back to surgical routine with elective procedures allowed after Covid19, so will try to adapt it a little.

While in these cases I don't use CO2 gas, nothing has to be changed. At the regular insufflation channel of the optic trocar I'm always applying suction to clear the peritoneal cavity from smoke so now I just need a filter to the suction device to filter possible contamination with virus, if any.

Laparoscopy during COVID19 - Total lift-laparoscopy hysterectomy CO2 is an Aerosol Generating Procedure (AGP), there is a high risk of explosive dispersion o...

27/04/2020

Laparoscopy and COVID-19
How to perform Laparoscopy without carbon dioxide to avoid Aerosols of Corona Virus?

CO2 is an Aerosol Generating Procedure (AGP), there is a high risk of explosive dispersion of aerosols during laparoscopic surgery with carbon dioxide.

Here is how we could minimize that risk by using Gasless Lift-Laparoscopy and exclude possible risks of CO2 laparoscopy.

Performing procedures under regional anesthesia we're also able to exclude the risk of intubation and thus make the procedure even safe to anesthetists and staff.
Cheers and keep safe!

26/04/2020

Laparoscopy and COVID-19
How to perform Laparoscopy without carbon dioxide and without intubation?

CO2 is an Aerosol Generating Procedure (AGP), there is a high risk of explosive dispersion of aerosols during laparoscopic surgery with carbon dioxide.

Here is how we could minimize that risk by using Gasless Lift-Laparoscopy and exclude possible risks of CO2 laparoscopy.

Performing procedures under regional anesthesia we're also able to exclude the risk of intubation and thus make the procedure even safe to anesthetists and staff.

Cheers and keep safe!
https://www.youtube.com/watch?v=1aqCyKKVV1M&t=17s

25/04/2020

Laparoscopy and COVID-19
How to perform Laparoscopy without carbon dioxide and without intubation?

There is a high risk of explosive dispersion of aerosols and body fluid during laparoscopic surgery, however laparoscopic surgery is associated with reduced morbidity, shorter hospital stays and quicker return to daily activities, all of which will benefit the patient, and make better use of hospital resources, particularly at the time of the current pandemic.

Here is how we could minimize that risk:

Using Gasless Lift-Laparoscopy we can exclude all risks and possible and theoretical disadvantages of current risks of laparoscopy:

1) Eliminating CO2 as Aerosol Generating Procedure (AGP)
2) Avoids contamination of OR-Room-Air with all dangerous aspects to surgeon and OR-Staff
3) Simultaneous smoke evacuation using suction through the insufflation channel of the optical trocar
4) Eliminating the contamination of instruments, insufflator and tubes
5) Excluding modulation of pneumonia-peritoneum (acidosis, hypercapnia) which even might increase the risk virus spreading or contamination of the peritoneal cavity
6) Excluding the risk of necessary hyperventilation during anesthesia
7) Possibility of performing procedures under regional anesthesia, so we exclude also the risk of intubation and thus make the procedure even safe to anesthetists and his staff

Cheers and keep safe!

Minimal Invasive Surgery under Minimal Invasive Anesthesia Bauchspiegelung ohne Vollnarkose Laparoskopie ohne Vollnarkose Laparoscopy without general anesthesia

25/04/2020

Laparoscopy and Covid-19 crisis
As laparoscopic surgeons we all support the current statements, guidelines and recommendation due to Covid-19 and laparoscopic procedures, which are considered Aerosol Generating Procedures (AGP) and thus we should „consider avoiding laparoscopy“ (1,2,3,4) or take precautions not to produce virus containing aerosols in the OR.
We all agree, that all elected laparoscopic procedures should be postponed, but we have plenty of emergency surgery like Ectopic pregnancy, Adnexal torsion, Appendectomy during pregnancy, Cancer surgery, Acute gallbladder, Acute hernia etcetera where we should at least
AVOID LAPAROTOMY!
There is a high risk of explosive dispersion of aerosols and body fluid during laparoscopic surgery, however laparoscopic surgery is associated with reduced morbidity, shorter hospital stays and quicker return to daily activities, all of which will benefit the patient, and make better use of hospital resources, particularly at the time of the current pandemic.
Everyone still knows me as the inventor of „Gasless Lift-Laparoscopy“ since 1991. As a back-Up Tool and especially in the Covid-19 crisis, where there is no evidence for anything, we can exclude all risks and possible discussions and use gasless Lift-Laparoscopy. It offers all advantages, we need to perform safe a laparoscopic procedure and excludes all possible and theoretical disadvantages of current risks of laparoscopy:
1) Eliminating Aerosol Generating Procedure (AGP)
2) Avoids contamination of OR-Room-Air with all dangerous aspects to surgeon and OR-Staff
3) Simultaneous smoke evacuation using suction through the insufflation channel of the optical trocar
4) Eliminating the contamination of instruments, insufflator and tubes
5) Excluding modulation of pneumonia-peritoneum (acidosis, hypercapnia) which even might increase the risk virus spreading or contamination of the peritoneal cavity
6) Excluding the risk of necessary hyperventilation during anesthesia
7) Possibility of performing procedures under regional anesthesia, so we exclude also the risk of intubation and thus make the procedure even safe to anesthetists and his staff
There are many other advantages, but I just want to stress on the possibility of performing safe Laparoscopy and avoid Laparotomy.
Few months ago I have introduced the new Abdo-Lift and if there will be some of you interested to learn how to perform gasless Lift-Laparoscopy, I’m planing to have webinars on how to perform gasless Lift-Laparoscopy.
Cheers and keep safe!
1) American College of surgeons
https://www.facs.org/c…/clinical-guidance/surgeon-protection
https://www.facs.org/covid-19/faqs
2) International Society for Gynecologic Endoscopy
https://www.facebook.com/Laparoscopy/posts/2844585172244888
3) SAGES recomendations
https://www.sages.org/recommendations-surgical-response-co…/
4) ESGE recommendations on LSC surgeries
https://esge.org/wp-cont…/…/2020/03/Covid19StatementESGE.pdf