Laparoscopic surgery by abdominal wall lifting using original lifting bars.

Laparoscopic surgery by abdominal wall lifting may be less invasive than by pneumoperitoneum, because the influence of the pneumoperitoneum can be avoided. We have performed laparoscopic surgery without pneumoperitoneum by lifting the full layer of the abdominal wall using two unique kinds of lifting bars that we developed. We have used this method on a total of 154 patients and obtained favorable results. Laparotomy was performed in three of the 104 patients undergoing cholecystectomy. All of them had previously undergone gastrectomy, and laparotomy was performed because of severe intraperitoneal adhesions. There were no severe complications, but insufficient suturing was experienced in one patient who underwent resection of the large intestine. In this article we describe the procedures and results of the lifting method.