The Straw Pressure Gradient and Gravity (SPGG) Technique: A Safe and Cost-Effective Technique for Laparoscopic Suction.

Suction devices are frequently used during laparoscopic surgery. However, their cost and limitations can be significant, depending on the clinical case, theatre setting and national health system. Furthermore, the continuous need to reduce the costs of the consumables in minimally invasive surgical procedures and their environmental burden creates extra pressure on the healthcare systems globally. Therefore, we present a new technique for laparoscopic suctioning, the Straw Pressure Gradient and Gravity (SPGG) technique. It is a safe, cost-effective and environmentally friendly technique compared to traditional suction devices. The technique involves using a sterile, single-use Suction Catheter 12-16 French after positioning the patient according to the targeted collection. The catheter is inserted via the laparoscopic port nearest the collection and directed using laparoscopic graspers. The outer end needs to be clamped to avoid fluid spillage, and the catheter tip is placed in the collection. Then after the clamp is released, the fluid will be successfully drained due to the pressure gradient into a pot placed at a lower level than the intra-abdominal collection. Minimal wash can be performed via the gas vent by using a syringe. SPGG is a safe and easy-to-learn technique that requires similar skills as placing an intra-abdominal drain during laparoscopy. It is softer than rigid, traditional suction devices and atraumatic. It can be used for suction, irrigation, collection of fluid for sampling and as a drain in case of an intraoperative indication. SPGG is a cost-effective device as it is cheaper than the average disposable suction device system and has multiple uses, which can significantly decrease the annual cost of laparoscopies. It can also reduce the number of consumables and lighten the environmental burden of laparoscopic procedures.