Direct Trocar Entry For Laparoscopy Safety and Efficiency

Ulusoy, Serap

doi:10.14744/less.2018.87609

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…Whereas when the supra umbilical incision was used, the skin incision often needed to be extended just to reach the fascia. This is similar to several studies which report that the open method is safer to practice (Ulusoy, 2018). In a cohort study showing injuries caused by closed techniques (veress needle) for the creation of pneumoperitoneum, the incidence of vascular injuries was 0.018 and visceral injuries was 0.0024 (De Azevedo et al, 2006).…”

Section: Discussionsupporting

confidence: 86%

Comparative study between true umbilical versus supra umbilical technique as an open access for pneumoperitoneum during laparoscopic surgery

Elashry

Hedaya

Abdelaziz

et al. 2022

ijhs

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Background: To start laparoscopic procedures, accessing the peritoneal cavity and establishing a carbon dioxide pneumoperitoneum are critical. The placement of the primary trocar is an important step in laparoscopic surgery. Many techniques have been reported in order to limit complications associated with the placement of the first trocar. In the study we describe a surgical method that offers quick, safe, and reliable preliminary entry into the peritoneal cavity with incredible functional and cosmetic results. Methods: A prospective randomised comparative study was conducted on 202 candidates for various laparoscopic surgery, comparing true umbilical versus supra umbilical open access for pneumoperitoneum from November 2021 to May 2022 in our surgical department. Results: There were 202 patients in the study, 109 (women) and 93 men. The port site entry per seconds was 41.3± 1.2 in true umbilical technique (group A) and 132.9± 5.5 in supra umbilical open technique (group B), and that was a statistically significant difference (p < 0.0001). There was a statistically significant difference in the mean time of port site wound closure (<0.0001) and port site gas leaking in the true umbilical access group compared to the supra umbilical access group (0.000161).

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Section: Discussionsupporting

confidence: 86%

Comparative study between true umbilical versus supra umbilical technique as an open access for pneumoperitoneum during laparoscopic surgery

Elashry

Hedaya

Abdelaziz

et al. 2022

ijhs

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“…Muneer imran reported just two complications port site hematoma 2% and port site infection 3% 13 . In another study only skin bleeding and ecchymosis was observed in 0.34% cases 22 .…”

Section: Discussionmentioning

confidence: 85%

Direct Trocar Insertion: an Efficient Access Technique for Laparoscopic Cholecystectomy

Baloch¹,

Shah²,

Shaikh³

et al. 2021

PJMHS

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Aim: To evaluate the feasibility and safety of direct trocar insertion for gaining access to peritoneal cavity in laparoscopic cholecystectomy. Methods: An Observational study was conducted at Surgical unit II Ghulam Mohammad Mahar Medical College Hospital Sukkur from January 2016 to December 2020. Two thousand one hundred twenty (n=2120) patients were included in the study. All the patients who underwent laparoscopic cholecystectomy were included in the study. Informed and written consent was obtained from every patient to participate as study subject. Data was analyzed on SPSS version 16. Mean +/- standard deviation was calculated for age, first port access time and time to establish pneumoperitoneum. Results: Under general anesthesia with patient in supine posture, abdominal access gained by first making small incision of 10mm in skin and subcutaneous fat at sub umbilical region with No. 11 scalpel and then by direct trocar insertion followed by creation of pneumoperitoneum. Cholecystectomy performed. Study variables included first port access time, no. of attempts for DTI, extraperitoneal CO2 insufflation, port site bleeding, visceral injury, port site infection and port site hernia and were recorded on predesigned proforma. Variables like extraperitoneal CO2 insufflation, port site bleeding and visceral injury were expressed as percentage. Conclusion: We conclude that direct trocar insertion is the safe, quick and effective method for creation of pneumoperitoneum and should be employed routinely in all laparoscopic procedures. Keywords: Laparoscpy, Cholecystectomy, Trocars

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“…In the study of Karthik et al, the incidence of trocar entry site bleeding was reported as 0.7%. [17] On the other hand, hematoma/ecchymosis rate after DTT was 0.36% in the study of Ulusoy et al [18] Bleeding at the first port of entry is mostly associated with tissue damage resulting from repeated attempts. On the other hand, it is recommended that trocars be placed under direct vision by illuminating the abdominal wall (transillumination), since trocar entry site bleeding is often caused by injury to the epigastric vessels at the secondary trocar entry.…”

Section: Discussionmentioning

confidence: 99%

Reliability of port entry techniques applied in laparoscopic surgery and their effects on postoperative outcomes

Kalaycı¹

2022

Laparosc Endosc Surg Sci

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Introduction: The aim of this study is to show the reliability of three different access techniques (Hasson Technique [HT], Veress Needle Technique [VNT], and Direct Trocar Technique [DTT]) commonly used in laparoscopic surgery and to investigate their effects on the early and late outcomes. Materials and Methods:This single-center cohort study was designed as a retrospective study (between May 2019 and July 2020) at a tertiary health center with 290 patients. Pre-operative, operative, and post-operative parameters were gathered from hospital archive system. Post-operative outcomes were divided into two categories: Early outcomes and late outcomes. Early outcomes were defined as complications detected within the first 30 days after surgery, while late outcomes were defined as complications occurring between 30 days and 1 year. The differences of the investigated parameters in the three insertion techniques were evaluated statistically.Results: HT was used in 113 (39%) patients, VNT in 104 (35.9%), and DTT in 73 (25.2%) patients. DTT was a preferred method at younger ages (P<0.001). Twelve (4.1%) patients had complications during the first trocar insertion. While both operative complications and visceral injury were higher in the DTT group, the rate of vascular injury was the same between all groups. The early outcomes were seen in 34 (11.7%) patients.. The rates of both subcutaneous emphysema and ecchymosis were significantly lower in the HT group, P=0.011 and P=0.008, respectively. On the other hand, late outcomes were seen in 9 (3.1%) patients. The rates of late outcomes were similar between all groups. Conclusion:HT is a reliable method for the first trocar insertion due to the low rates of operative complications, and low incidence of early complications.

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Direct Trocar Entry For Laparoscopy Safety and Efficiency

Abstract: Introduction: This study is an examination of the safety and efficiency of the direct trocar entry method used to create pneumoperitoneum in laparoscopic surgery.

Cited by 4 publications

References 7 publications

Comparative study between true umbilical versus supra umbilical technique as an open access for pneumoperitoneum during laparoscopic surgery

Comparative study between true umbilical versus supra umbilical technique as an open access for pneumoperitoneum during laparoscopic surgery

Direct Trocar Insertion: an Efficient Access Technique for Laparoscopic Cholecystectomy

Reliability of port entry techniques applied in laparoscopic surgery and their effects on postoperative outcomes

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