The Use of Towel Clips in Open Access laparoscopic technique. A novel innovation.
Background
Gas leakage is a major concern of any minimal access surgeon during laparoscopy especially in open access technique. Towel clips have been known to be of benefit in surgical draping. It has been also reported in literature to be of use in skin retraction during laparoscopic access. However, its use to prevent gas leakage has not been explored.
Aim This is to report the usefulness of towel clips in open access technique of laparoscopy, in preventing gas leakage.
Methods
The routine skin preparation for laparoscopy was done. The Backhaus towel clamp was used to hold and stabilize the edge(s) of the 10mm cannula, in order to provide air tight intra-abdominal condition and prevent gaseous leakage. Cetrimide containing chlorhexidine was used to assess leakage. Bubbles of gas peri canular signifies leakage.
Results.
There was no leakage at flow rate of 2litres per minute. The usual flow rate of 6litres per minute with subsequent increase up to 12litres per minute sustained the desired pressure during procedure and no gas leak was noted in cases were towel clip was used. Hence, the actual intra-abdominal pressure fluctuated within the preset pressure of 12mmHg and 15mmHg.
Conclusion
Towel clips besides its use as draping and retraction instrument, can be very useful in prevention of gas leakage in open access technique during laparoscopic surgery.
Key words: The Usefulness. Towel Clips. Open Access technique of laparoscopy, means of prevention, gas leakage.
