Laparoscopic entry: a literature review and analysis of techniques and complications of primary port entry

Molloy, D. William; Kaloo, Philip; Cooper, Michael; Nguyen, Tuan V.

doi:10.1111/j.0004-8666.2002.00246.x

Cited by 226 publications

(154 citation statements)

References 59 publications

(59 reference statements)

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“…Pnömoperitoneumun oluflmay›fl›, preperitoneal insuflasyon, intestinal insuflasyon ve CO2 embolizmi gibi Veres i¤nesi kullan›m› ile iliflkili komplikasyonlar›n direkt trokar ile giriflte oluflmad›¤›n› savunmufllard›r (28) . Direk trokar girifl yöntemi di¤er yöntemlerden h›zl›d›r buna ra¤men klinik pratikte en az kullan›lan yöntemdir (29,30) . Teknik flu flekilde tan›mlanm›flt›r.…”

Section: G‹r‹fiunclassified

Different Access Areas, Access Techiques and Trocar Types in Transperitoneal Laparoscopy

Bozkurt¹,

Yumru²

2013

J Turk Soc Obstet Gynecol

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(1,2) . Bundan baflka laparoskopik cerrahinin laparatomik cerrahiye oranla daha az komplikasyon h›z›na sahip oldu¤una dair veriler mevcuttur (3,4) . Laparoskopik cerrahinin relatif güvenli olmas›na ra¤men istenmeyen ciddi ba¤›rsak, mesane ve vasküler hasara neden olmas›, komplike ekipmanlar gerektirmesi ve uzun ö¤renme e¤risi kullan›m›n› k›s›tlamaktad›r (5,6) . Ciddi komplikasyonlar›n ço¤u trokar yerleflimi ile iliflkilidir (7,8) . Bu DIFFERENT ACCESS AREAS, ACCESS TECHNIQUES AND TROCAR TYPES IN TRANSPERITONEAL LAPAROSCOPY SUMMARYLaparoscopy has enabled a radical change of practice for surgeons over the last two decades. In general, laparoscopic surgery leads to less scarring, less postoperative pain and more rapid healing rates compared to laparotomy (1,2) . Data are also available indicating that laparoscopic surgery has lesser complication rates compared to laparotomic surgery (3,4) . Although laparoscopic surgery is relatively safe, its causes unwanted and severe intestinal, bladder and vascular injury, requiring complicated equipment and a long learning curve limit is required for surgeons to master its use (5,6) . Most of the severe complications are related to trocar insertion (7,8) .

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Section: G‹r‹fiunclassified

Different Access Areas, Access Techiques and Trocar Types in Transperitoneal Laparoscopy

Bozkurt¹,

Yumru²

2013

J Turk Soc Obstet Gynecol

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“…A 12-cm reusable Veress needle with a 2-mm external diameter was inserted into the abdominal wall through an incision in the left hypochondrium to create carbon dioxide pneumoperitoneum. After needle insertion, the five tests encompassing the ( i) aspiration test (AT), (ii) injection test (IT), (iii) recovery test (RT), (iv) saline drop test (SDT), and (v) initial intraperitoneal pressure test (IIPT) 12 10 [mmHg] were performed [1], [12]. Details for such tests may be found in [5].…”

Section: B Surgical Data Collectionmentioning

confidence: 99%

“…The most employed technique to gain access to the peritoneal cavity in order to produce pneumoperitoneum is by using Veress needle puncture [1]. Unfortunately, regardless the technique used to achieve this access, most of the surgical complications occurs at the moment of accomplishing the pneumoperitoneum [2].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopy Pneumoperitoneum Fuzzy Modeling

Becker¹,

Araújo²,

Azevedo³

2011

Nature Precedings

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Abstract-Gas volume to intra-peritoneal pressure fuzzy modeling for evaluating pneumoperitoneum in videolaparoscopic surgery is proposed in this paper. The proposed approach innovates in using fuzzy logic and fuzzy set theory for evaluating the accuracy of the prognosis value in order to minimize or avoid iatrogenic injuries due to the blind needle puncture. In so doing, it demonstrates the feasibility of fuzzy analysis to contribute to medicine and health care. Fuzzy systems is employed here in synergy with artificial neural network based on backpropaga tion, multilayer perceptron architecture for building up numerical functions. Experimental data employed for analysis were col-lected in the accomplishment of the pneumoperitoneum in a random population of patients submitted to videolaparoscopic surgeries. Numerical results indicate that the proposed fuzzy mapping for describing the relation from the intra peritoneal pressure measures as function injected gas volumes succeeded in determnining a fuzzy model for this nonlinear system when compared to the statistical model.

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“…4,5 Overall incidence of major injuries at the time of laparoscopic entry is 1.1 per 1000. 6 According to a recent Cochrane database of systematic reviews published in Cochrane library 2015, there was no evidence of advantage using any single technique for preventing major vascular or visceral complications. Due to imprecision and lack of reporting of study methods the evidence obtained was of poor quality.…”

Section: Introductionmentioning

confidence: 99%

Risks and benefits of two different entry techniques for laparoscopic gynecological surgeries

Agarwal

Yadav

Agarwal

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Primary abdominal access still remains a challenge for laparoscopic surgery despite rapid advances. This study was conducted to prospectively analyse and compare risks and benefits of two different entry techniques namely, veress needle and direct trocar in laparoscopic gynaecological surgeries so as to obtain consensus on the optimal method to be followed to create pneumoperitoneum.Methods: This was a prospective randomized study conducted at Deen Dayal Upadhyay hospital, under Delhi government. During the period January 2014 to June 2016, 800 patients (20-65 years) operated laparoscopically by the same team of surgeons for various gynaecological conditions, were randomized in two groups: Veress needle group (VN) and Direct trocar group (DT). Each group comprised of 400 patients. Comparison of various parameters was done between the two groups.Results: Incidence of major complications in terms of visceral injuries was 0.75% (3/400) in DT group and nil in VN group. Open conversion rate (2/400 i. e. 0.5%) and number of attempts required to create pneumoperitoneum were also more in DT group. Failed access in previous surgery cases was 1.2% (1/38) in VN and 14.8% (4/27) in DT group. Incidence of port site bleeding (n=3) was also more in DT group. Although the incidence of minor complications such as extraperitoneal insufflations (n=5) and no. of failed access (n=6) were more in VN group, there was no incidence of any life-threatening complication.Conclusions: In our experience, there is clear evidence of advantage of using veress needle in preventing major complications. Veress needle is therefore safer, convenient and effective technique of creating pneumoperitoneum.

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Laparoscopic entry: a literature review and analysis of techniques and complications of primary port entry

Abstract: There remains no clear evidence as to the optimal form of laparoscopic entry in the low-risk patient. However, direct entry may be an under-utilised and safe alternative to the Veress needle and open entry technique.

Cited by 226 publications

References 59 publications

Different Access Areas, Access Techiques and Trocar Types in Transperitoneal Laparoscopy

Different Access Areas, Access Techiques and Trocar Types in Transperitoneal Laparoscopy

Laparoscopy Pneumoperitoneum Fuzzy Modeling

Risks and benefits of two different entry techniques for laparoscopic gynecological surgeries

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