Clinical Perspective Concerning Abdominal Entry Techniques

Recknagel, Johnathon D.; Goodman, Linnea R.

doi:10.1016/j.jmig.2020.07.010

Cited by 8 publications

(3 citation statements)

References 30 publications

(37 reference statements)

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“…The ideal entry site takes into account and maximizes all of the following factors: (1) avoidance of important extra-abdominal and intra-abdominal structures; (2) technical ease of entry and surgeon comfort with the technique; (3) patient risk factors such as prior surgery; and (4) proximity to the operative site or pathology of interest. 11 In case of previous upper abdominal surgery, Palmer point and Lee-Huang point may be dangerous to use. Lee-Huang point is not suitable for laparoscopy after upper abdominal surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…Recknagel and Goodman described a methodical approach to entering the abdomen that begins with choosing an appropriate location for the initial entry. The ideal entry site takes into account and maximizes all of the following factors: (1) avoidance of important extra-abdominal and intra-abdominal structures; (2) technical ease of entry and surgeon comfort with the technique; (3) patient risk factors such as prior surgery; and (4) proximity to the operative site or pathology of interest 11…”

Section: Discussionmentioning

confidence: 99%

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A New Laparoscopic Entry Point in Patients With Previous Laparotomy: A Prospective Comparative Study

Elbanna¹,

Helmy²,

Sabry³

et al. 2022

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Introduction: Intraperitoneal access and establishing pneumoperitoneum for laparoscopy is a critical step especially in patients who underwent previous laparotomy due to the higher risk of visceral or vascular injuries. In this study, we propose a new entry point for safe laparoscopic access in cases having previous laparotomy. Materials and Methods: This is a prospective controlled randomized trial conducted between January 2016 and January 2022 in Ain Shams University Hospitals. It included 232 patients who underwent laparoscopic procedures after previous laparotomy. They were randomly divided into 2 equal groups. In group 1, laparoscopic access was carried out by an optical trocar through the new point situated in the subxiphoid region 1 cm below the costal margin and centered 2.5 cm from the midline on either side. In group 2, laparoscopic access was performed by an optical subumbilical trocar after Verres needle insufflation in Palmer point. The primary end points were success and safety of entry, measured by the number of entry attempts and the incidence of bowel and vascular injuries. The secondary end point was the entry time. Results: In group 1, safe entry into the abdomen was achieved without visceral or vascular injury. In the 3 cases, minor liver injuries occurred. In group 2, 2 major vascular injuries and 5 bowel injuries occurred. There was a significant difference in procedure time (55±7.2 s in group 1 vs. 192±11.6 s in group 2). Conclusion: The suggested entry point is fast, safe, and reliable in patients having previous laparotomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A New Laparoscopic Entry Point in Patients With Previous Laparotomy: A Prospective Comparative Study

Elbanna¹,

Helmy²,

Sabry³

et al. 2022

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

View full text Add to dashboard Cite

show abstract

“…Mohapatra and Bhusan [38] have also reported the benefit of the left lateral port as the main working port as well as the entry port, indicating dual benefit with good ergonomics. In a recent article "Clinical Perspective Concerning Abdominal Entry Techniques" published in JMIG (Journal of Minimally Invasive Surgery), Goodman L, et al have also illustrated our Jain point as one of the abdominal entry ports [39].…”

Section: Discussionmentioning

confidence: 99%

Jain point: an alternate laparoscopic non-umbilical first blind entry port to avoid vessel, viscera, adhesions and bowel (VVAB)

Jain

Chandi

et al. 2021

Updates Surg

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The Jain point entry is based on the concept of non-umbilical entry to avoid sudden catastrophic injury to major retroperitoneal vessels, viscera, adhesions and bowel which could happen before the start of procedure by blind umbilical entry. To study the safety and efficacy of a novel first non-umbilical blind entry port. Tertiary referral centre for advanced laparoscopic surgeries with active training and fellowship programs. A large retrospective study of 7802 cases done at Vardhman Infertility & Laparoscopy Centre from January 2011 to December 2020. In all cases, first blind entry was by veress needle and 5 mm trocar and telescope through a non-umbilical port, The Jain point, irrespective of BMI, large masses, lax abdomen, previous surgery and complex situations. Patients’ demographic profile, types of surgeries performed and entry-related complications were recorded and analysed. Mean age of patients was 33 years with BMI ranging from 12.66 to 54.41 kg/m2. Thus, Jain point can be applicable for all ranges of BMI, all types of surgeries from simple to complex and large masses. Entry related minor complications were in 3.4% cases while major complication involving bowel occurred in one case. No case of injury to major retro-peritoneal vessel was seen. Jain point entry is a novel, first blind 5 mm non-umbilical, entry technique in a variety of surgeries and previous scars and patients with wide range of BMI. It has a short learning curve and continues as main ergonomic working port.

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