LAPAROLIFTING IN PERFORMING LAPAROSCOPIC CHOLECYSTECTOMY IN PATIENTS WITH COVID-19

Starting in March 2020, when doctors faced the onset of the coronavirus disease (SARS-CoV-2) pandemic, the surgical service faced new challenges: the growth in abdominal emergencies and the presence of the COVID-19 as a concomitant disease. Respiratory infection requires finding ways to improve the performance of surgical laparoscopic interventions, since all patients have respiratory disorders. One method that can help is laparolifting or "gasless laparoscopy." The aim of the study was to investigate the efficacy and safety of the gasless laparoscopy (laparolifting) method for endoscopic cholecystectomy in patients with COVID-19 co-infection. We analyzed the clinical data of patients with acute destructive cholecystitis and COVID-19 co-infection who underwent laparoscopic cholecystectomy by applying a laparolifting device and compared them with standard surgery by using carboxy-peritoneum. According to the data obtained, we can suggest that the use of "gasless laparoscopy" method in the presence of respiratory distress syndrome in patients with COVID-19 reduces the need to increase the peak inspiratory pressure during intubation anesthesia, and over the postoperative period this method has a positive effect on the patients’ need in oxygen to achieve the good saturation. Having analyzed laboratory parameters, we can conclude that both methods are comparable and do not cause critical shifts in the body's homeostasis. According to our study, laparolifting is a safe technique that also reduces pain syndrome intensity after surgery and does not seriously restrain the patient's activity. Therefore, we can recommend the use of laparolifting when performing laparoscopic cholecystectomy in patients with COVID-19.