Direct trocar insertion versus veress needle insertion in laparoscopic cholecystectomy

Yerdel, Mehmet Ali; Karayalçın, Kaan; Koyuncu, Ayhan; Akın, Barış; Köksoy, Cüneyt; Türkçapar, Ahmet Gökhan; Erverdi, Nezih; Alaçayir, İskender; Bumin, Cihan; Aras, Nusret

doi:10.1016/s0002-9610(99)00020-3

Cited by 70 publications

(61 citation statements)

References 2 publications

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“…In gynecologic laparoscopic surgery, the Veress needle puncture method was found to increase minor complications compared with both the open and direct trocar insertion tech-niques (18). Direct trocar insertion may be a safe technique in thin patients (19)(20)(21).…”

Section: Safe Cholecystectomy A) What Are the Essentials Of Safe Lapamentioning

confidence: 99%

Prevention and acute management of biliary injuries during laparoscopic cholecystectomy: Expert consensus statement

Abbasoğlu¹,

Tekant²,

Alper³

et al. 2016

UCD

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Gallstone disease is very common and laparoscopic cholecystectomy is one of the most common surgical procedures all over the world. Parallel to the increase in the number of laparoscopic cholecystectomies, bile duct injuries also increased. The reported incidence of bile duct injuries ranges from 0.3% to 1.4%. Many of the bile duct injuries during laparoscopic cholecystectomy are not due to inexperience, but are the result of basic technical failures and misinterpretations. A working group of expert hepatopancreatobiliary surgeons, an endoscopist, and a specialist of forensic medicine study searched and analyzed the publications on safe cholecystectomy and biliary injuries complicating laparoscopic cholecystectomy under the organization of Turkish Hepatopancreatobiliary Surgery Association. After a series of e-mail communications and two conferences, the expert panel developed consensus statements for safe cholecystectomy, management of biliary injuries and medicolegal issues. The panel concluded that iatrogenic biliary injury is an overwhelming complication of laparoscopic cholecystectomy and an important issue in malpractice claims. Misidentification of the biliary system is the major cause of biliary injuries. To avoid this, the "critical view of safety" technique should be employed in all the cases. If biliary injury is identified intraoperatively, reconstruction should only be performed by experienced hepatobiliary surgeons. In the postoperative period, any deviation from the expected clinical course of recovery should alert the surgeon about the possibility of biliary injury.

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Section: Safe Cholecystectomy A) What Are the Essentials Of Safe Lapamentioning

confidence: 99%

Prevention and acute management of biliary injuries during laparoscopic cholecystectomy: Expert consensus statement

Abbasoğlu¹,

Tekant²,

Alper³

et al. 2016

UCD

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“…(15) Direct trocar entry is only one blind cutting maneuver in D.T.I. as against that of veress needle: two blind enteries with one intervening blind insufflation, insufflaion and trocar insertion.…”

Section: Discussionmentioning

confidence: 99%

Pneumoperito Neum by Direct Trocar Insertion : Safe Laparoscopic Access

Kumar¹,

Hastir²,

Bandlish³

2015

jemds

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Purpose of this study is to access the safety and efficacy of direct trocar insertion (DTI) for accessing the abdominal cavity for operative laparoscopy without prior pneumoperitoneum. DTI is one of the safe and effective alternative to veress needle insertion, open access (Hassan's technique) and visual entry systems (disposable optic trocars and endotip visual cannula) in laparoscopic surgery. METHODS: The study included 2480 patients who has undergone laparoscopic procedures at civil hospital, Jalandhar from Nov. 2003 to Sept. 2012 and at Punjab Institute of Medical Sciences (PIMS) Jalandhar from Sept. 2012 to June 2014. Procedures include 2310 laparoscopic cholecystectomies, 148 laparoscopic appendectomies, 10 cases of TAPP Groin hernia repairs and 12 cases of simple ovarian cysts. For DTI, abdominal wall was lifted and trocar was pushed through the fascia and muscle layer. The surgeon felt click when the trocar had pierced the peritoneum and entered the abdominal cavity. RESULTS: Direct trocar insertion was feasible in 100% of patients. There was no evidence of intestinal or vascular injury during trocar placement. Peritoneal access and creation of laparoscopic workspace were attained faster and more efficiently by the DTI technique. CONCLUSIONS: DTI is a fast, safe and reliable alternative to traditional techniques of primary port placement in laparoscopic procedures for creation of pnuemoperitoneum. KEYWORDS: Direct trocar insertion (DTI), Pneumoperitoneum, veress needle (VN), Laparoscopy. INTRODUCTION:The establishment of pneumoperitoneum is a pre-requisite for most laparoscopic surgeries and the method used is not necessarily dependent on the procedure for which it is intended. Over the last decade rapid increase has occurred in both the applications of operative laparoscopy and the number of surgeons using this technique. Laparoscopic abdominal surgery requires the establishment of successful pneumoperitoneum in the vast majority of patients with more than half of all the complications occurring at the time of entry into abdomen.The rationale for an adequate pneumoperitoneum is that it provides buffer space between the insertion site and pelvis or abdominal viscera. Several techniques and technologies have been introduced over the past 50 years to minimize laparoscopic related injuries. The standard technique of insufflation after insertion of Veress needle, open laparoscopy involving opening of the peritoneum under direct vision (Hasson's method), optical trocar insertion and direct trocar insertion (DTI) as well as variants of these techniques.Recent experiences with laparoscopy has revealed significant complication associated with Veress needle insufflation such as gas embolism, subcutaneous emphysema, failed pneumoperitoneum with resultant failed laparoscopy and bowel and visceral insufflations. (1, 2) Open assess as described by Hasson in 1971 (3) has shown to minimize vascular injuries but does not reduce bowel injury. Also open access is complicated by gas leak and port instability.

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“…Essa indicação baseou-se no fato de a obtenção do pneumoperitônio pela técnica fechada com a agulha de Veress estar associada a vários relatos de lesões viscerais (Yerdel et al 1999, Zaraca et al 1999, assim como pelo considerável risco de lesões em consequência da punção às cegas do primeiro trocarte (Malm et al 2004, Azevedo et al 2004, principalmente ao se trabalhar com animais de menor porte como no presente caso.…”

Section: Discussionunclassified

Nefrectomia videolaparoscópica em Graxaim-do-campo (Pseudalopex gymnocercus) com displasia renal

et al. 2014

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Pesq. Vet. Bras. 34(8):776-779, agosto 2014 776 RESUMO.-Graxains-do-campo habitam o centro-leste da América do Sul, desde o sudeste do Brasil e leste da Bolí-via. A displasia renal compreende um espectro de anomalias e é frequentemente relatada em cães de diversas raças, sendo a maioria dos relatos achados de necropsia. A maior parte das doenças renais congênitas nos cães apresenta caráter progressivo, portanto o tratamento é limitado e direcionado a fim de retardar a progressão da doença renal estabelecida. No presente relato é descrita a realização de nefrectomia laparoscópica em graxaim-do-campo (Pseudalopex gymnocercus) com displasia renal. Suspeitou-se de doença no rim direito por meio de ultrassonografia e urografia excretora. Para o procedimento cirúrgico foram utilizados três portais (10, 10, 5mm), endoscópio rígido de 10mm/0 0 e clipes para hemostasia dos vasos renais. A téc-nica cirúrgica utilizada neste canídeo selvagem foi semelhante à usada em cão doméstico, devido à escassez de relatos em cirurgias em graxaim e a inexistência de descrições de nefrectomia videolaparoscópica em graxaim-do-campo. O animal foi acompanhado por um período de 30 dias pós--cirurgia sem a ocorrência de complicações. O presente relato demonstra que a técnica proposta foi adequada para a realização de nefrectomia videolaparoscópica em Graxaim--do-campo. Nefrectomia videolaparoscópica em

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Direct trocar insertion versus veress needle insertion in laparoscopic cholecystectomy

Cited by 70 publications

References 2 publications

Prevention and acute management of biliary injuries during laparoscopic cholecystectomy: Expert consensus statement

Prevention and acute management of biliary injuries during laparoscopic cholecystectomy: Expert consensus statement

Pneumoperito Neum by Direct Trocar Insertion : Safe Laparoscopic Access

Nefrectomia videolaparoscópica em Graxaim-do-campo (Pseudalopex gymnocercus) com displasia renal

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