The objective of our study was to evaluate the technical advantages of using the Laparolift device and examine the clinical benefits of gynecologic laparoscopy without pneumoperitoneum. A randomized single-blinded clinical trial was performed employing a sample of 30 consecutive patients undergoing laparoscopic gynecologic surgery with a primary outcome measure of visualization. Visualization was found to be inferior in gasless patients. The conclusion was that conventional laparoscopy employing pneumoperitoneum provides surgical exposure superior to that offered by the Laparolift device.