Our Experience of Open Technique of Creating Pneumoperitoneum through Umbilical Cicatrix from a Remote Health Facility at Nepal

Abstract

Background: Two methods have been used for peritoneal access to create pnemoperitoneum-the open and the closed technique. We are describing here an open technique of creating pneumoperitoneum through the umbilical cicatrix. We have been using this technique routinely in view of its safety, rapidity and technical ease. Materials and methods: This method was used in 156 patients serially to create pneumoperitoneum. Patients were followed at 10 days, 3 months and 1 year interval. Results: The time range was 22 to 540 seconds. The mean time taken was 85 seconds. More than 70% of the patients (n = 110) fell in the range of 22 to 80 seconds where as 36 were in the range of 80 to 100 seconds. Ten patients had the range of 100 to 540 seconds. There were no incidences of vessel or viscus injury even in reoperative cases. There were no cases of any major bleeding or hematoma. Two cases had wound infection which subsided with antibiotic and wound drainage. Out of 42 patients who have completed 3 months follow-up and 11 patients who have completed 1 year followup, none showed any port site hernia. Conclusion: The open technique of creating pneumoperitoneum through the umbilical cicatrix is a safe and rapid technique.