Laparoscopic Entry Techniques

Ahmad, Gaity; Duffy, James M N; Phillips, Kevin G.; Watson, Andrew

doi:10.1002/14651858.cd006583.pub2

Cited by 111 publications

(75 citation statements)

References 31 publications

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“…4,6–8,10,20 Some claim that the method they do not use is inferior or even hazardous, but the fact remains that there is no evidence to support their views.…”

Section: Discussionmentioning

confidence: 99%

Direct Trocar Insertion for Laparoscopy

Agresta

Mazzarolo

Bedin

2012

JSLS

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“…4,6–8,10,20 Some claim that the method they do not use is inferior or even hazardous, but the fact remains that there is no evidence to support their views.…”

Section: Discussionmentioning

confidence: 99%

Direct Trocar Insertion for Laparoscopy

Agresta

Mazzarolo

Bedin

2012

JSLS

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“…There is no advantage of one over the other; and therefore, no clear consensus concerning the optimal method of entry exists. [2]…”

Section: Discussionmentioning

confidence: 99%

“…[26] Visual entry cannula system represents an advantage over the traditional trocars as it allows clear visual entry. These can minimise size of the entry wound; however, evidence is lacking concerning its superiority over the traditional trocars, especially in avoiding visceral and vascular injuries.…”

Section: Discussionmentioning

confidence: 99%

Veress needle insertion through left lower intercostal space for creating pneumoperitoneum: Experience with 75 cases

Kumar¹

2012

J Min Access Surg

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CONTEXT:Veress needle insertion (VNI) at sub-umbilical fold (SUF) midline is associated with serious intra-abdominal injuries.AIM:The aim of this study has been to evaluate the safety and efficacy of lower left intercostal space (LICS) for VNI.SETTINGS AND DESIGN:This prospective observational study was conducted in three parts in Surgery-II, Department of Surgery, GTBH-UCMS, Delhi.MATERIALS AND METHODS:In part one, skin fold thickness (SFT) was measured in 32 patients at SUF, LICS, right iliac fossa (RIF) and Palmer's point. As part two, in these patients, VNI was carried out from LICS under laparoscopic guidance. As part three, same technique of VNI was employed in 43 patients with suspected intra-abdominal adhesions undergoing laparoscopy for various reasons. Observations were made regarding ease of insertion, attempts needed for successful entry, loudness or clarity of give-way feeling of Veress needle, intra-abdominal bleeding at point of emergence of Veress needle, hemopneumothorax, bowel or vascular injury.STATISTICAL ANALYSIS USED:SFT was expressed as mean (SD), and one-way ANOVA followed by Tukey's test were employed to find the statistical significance.RESULTS:SFT at LICS was significantly less as compared to SUF and Palmer's point. VNI at LICS was easy to carry out; it could be successfully done in first attempt in all patients, and was associated with very clear and loud give-way feeling. There were no instances of intra-abdominal bleeding at point of emergence of Veress needle, hemopneumothorax, bowel or vascular injury.CONCLUSIONS:VNI at LICS as described here is safe and effective.

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“…Moreover, this method is inexpensive. A systematic review of laparoscopic entry techniques published in 2008 concluded that there were no benefits in terms of safety of one technique compared with another [10]. This review did not specify the attitude in obese patients.…”

Section: Discussionmentioning

confidence: 99%