Gasless laparoscopic cholecystectomy. Selective intervention in a high surgical risk patient

Gasless laparoscopic cholecystectomy. Treat- ment of choice in a high surgical risk patient. Disadvantages related to CO2 pneumoperito- neum in high risk patients (anaesthesiologic c1assification in m and IV ASA), have led to the development of the abdominal wa11 retractor , a device designed to facilitate laparoscopic sur- gery without conventiona1 pneumoperitoneum. A case of a patient with acute cholecystitis, wen- compensated liver cirrhosis, and high respi- ratory and cardiologic risk (ASA m c1ass), sub- mitted to laparoscopic cholecystectomy with gasless technique is reported.