184: Open Laparoscopic Access Technique: Review of 8 Years Experience

Long, Jaime B.; Magrina, Javier F.

doi:10.1016/j.jmig.2007.08.149

Cited by 7 publications

(12 citation statements)

References 9 publications

(18 reference statements)

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“…There are many older randomized controlled as well as recent studies reporting the open technique as quick and associated with fewer minor complications. 12,[14][15][16][17][18][19][20][21] We are in agreement with the present series which report that this technique can be used routinely in the obese and in patients with previous abdominal surgery. 22 This modified open technique for gaining access into the abdominal cavity affords several distinct advantages over the conventional direct open technique or Veress needle.…”

Section: Discussionsupporting

confidence: 89%

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Modified Hasson technique versus Veress technique: a comparative study

George¹,

Mathew²,

Radhakrishna

et al. 2019

Int Surg J

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Background: There are two techniques of port placement for laparoscopy, Veress and Hasson. Both have their own advantages of disadvantages. Plenty of new modifications of these techniques have been tried to reduce the risks. We modified Hasson’s technique and evaluated whether the technique is better than the standard Veress technique.Methods: A retrospective analysis was carried out in the Department of General Surgery, Al Azhar Medical College Hospital, India from January 2013 to December 2018.Results: There were 156 patients in group A who underwent laparoscopy by Modified Hasson technique. The Veress technique was used in 149 patients who belonged to group B. There was no difference between the two groups in terms of age and indications for the surgery. The entry time (the time to place the first port) for group A was significantly lesser than that of group B (2.08±0.65 min vs. 4.59±0.53 min; p=0.000). There were a total of two complications in group A which was significantly lesser than that of group B (14; p=0.002). There was no significant difference between the two groups in terms of extraperitoneal port placement, intraperitoneal injury, failure to enter the abdomen, port site seroma, port site infection, port site hematoma, and mortality. But, port site hematoma was significantly lesser in group A compared to group B (0 vs. 5; p=0.027).Conclusions: Modified Hasson’s entry was found to be much better than Veress needle entry due to its simplicity for beginners in laparoscopy, lesser time of achieving pneumoperitoneum and lesser duration of surgery in our study.

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Section: Discussionsupporting

confidence: 89%

“…There are a few other studies that are similar to our study. 12,[19][20][21] Authors report similar advantages and encouragement using a modified open technique. We found subtle differences in these techniques compared to ours.…”

Section: Discussionmentioning

confidence: 85%

Modified Hasson technique versus Veress technique: a comparative study

George¹,

Mathew²,

Radhakrishna

et al. 2019

Int Surg J

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“…This is consistent with published literature in both North America and Europe. [22][23][24] This open technique contrasts the preferred closed Veress needle insufflation primary entry technique favoured by about 80% of gynecologists. 12 The reasoning behind this striking contrast in laparoscopic entry techniques between surgical disciplines is difficult to explain; however, it appears to be related to teaching patterns during residency and clinical experience.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic entry: a review of Canadian general surgical practice

Compeau

2011

Can J Surg

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Background: Laparoscopic surgery has gained popularity over open conventional surgery as it offers benefits to both patients and health care practitioners. Although the overall risk of complications during laparoscopic surgery is recognized to be lower than during laparotomy, inadvertent serious complications still occur. Creation of the pneumoperitoneum and placement of laparoscopic ports remain a critical first step during endoscopic surgery. It is estimated that up to 50% of laparoscopic complications are entry-related, and most injury-related litigations are trocar-related. We sought to evalu ate the current practice of laparoscopic entry among Canadian general surgeons. Methods:We conducted a national survey to identify general surgeon preferences for laparoscopic entry. Specifically, we sought to survey surgeons using the membership database from the Canadian Association of General Surgeons (CAGS) with regards to entry methods, access instruments, port insertion sites and patient safety profiles. Laparoscopic cholecystectomy was used as a representative general surgical procedure. Results:The survey was completed by 248 of 1000 (24.8%) registered members of CAGS. Respondents included both community and academic surgeons, with and without formal laparoscopic fellowship training. The demographic profile of respondents was consistent nationally. A substantial proportion of general surgeons (> 80%) prefer the open primary entry technique, use the Hasson trocar and cannula and favour the periumbilical port site, irrespective of patient weight or history of peritoneal adhesions. One-third of surgeons surveyed use Veress needle insufflation in their surgical practices. More than 50% of respondents witnessed complications related to primary laparoscopic trocar insertion. Conclusion:General surgeons in Canada use the open primary entry technique, with the Hasson trocar and cannula applied periumbilically to establish a pneumoperitoneum for laparoscopic surgery. This surgical approach is remarkably consistent nationally, although considerably variant across other surgical subspecialties. Peritoneal entry remains an important patient safety issue that requires ongoing evaluation and study to ensure translation into safe contemporary clinical practice.Contexte : La chirurgie laparoscopique a gagné en popularité par rapport à la chirurgie ouverte classique en raison des avantages qu'elle offre, tant pour les patients que pour les professionnels de la santé. Même si on reconnaît que le risque global de complications est moindre durant la chirurgie laparoscopique que durant la laparotomie, il survient parfois par inadvertance des complications graves. La création d'un pneumopéritoine et l'installation des dispositifs d'accès laparoscopiques demeurent une première étape cruciale lors de toute chirurgie endoscopique. On estime que jusqu'à 50 % des complications laparoscopiques sont liées à l'insertion et que la plupart des poursuites pour traumatisme mettent en cause une lésion causée par le trocart lui-même. Nous avons vo...

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“…There are many older randomized controlled 14 – 18 as well as recent studies 12 , 19 – 21 reporting the open technique as quick and associated with fewer minor complications. We are in agreement with all the present series that report that this technique can be used routinely in the obese and in patients with previous abdominal surgery.…”

Section: Discussionmentioning

confidence: 99%