VarioLift retraction system for laparoscopy without pneumoperitoneum

Abstract

Summary There are adverse effects due to the pneumoperitoneum during laparoscopic surgery, therefore the question of alternative procedures for retracting the abdominal wall has increasingly been discussed. So far, various systems which mechanically retract the abdominal wall have been introduced. However, due to their complicated design or limited visibility, they have not become popular. The modular retraction system (VarioLift, AESCULAP) consists of two components — a retractor for lifting the anterior abdominal wall and a hold-down device for compressing bulging internal organs. Both parts of the abdominal wall retractor are inserted in sequence through a 1.5 cm minilaparotomy and are, after being connected to each other, fixed to a mechanical lifting arm. The parts are available in various sizes and shapes, so that the retractor can be adapted to the respective abdominal quadrant and the anatomic situation of the patient. After lifting the anterior abdominal wall, the hold-down device is inserted, unfolded and positioned to hold down bulging internal organs. In contrast to other retraction systems, the VarioLift system allows the anterior abdominal wall to be raised in a dome-shaped fashion, offering good lateral visibility. The construction of the system, including the minilaparotomy, does not take any longer than the installation of a pneumoperitoneum.