The ‘Credence’ Technique for the Confirmation of Accurate Placement of Veress Needle

Abstract

Patients: Eleven patients from 16 to 72 years old, with adnexal cysts palpable above the umbilical scar. All patients complained of increased abdominal volume and/or pain, and were referred and operated by the Gynecologic Laparoscopic Group. Intervention: Laparoscopic approach of the giant cysts using a direct insertion of an umbilical trocar into the cyst and aspiration of all its contents, with no or minimal cyst fluid's spillage. Measurements and Main Results: All surgeries started with the direct insertion of an 11-mm umbilical trocar into the cyst and aspiration of its content. The largest diameter of the cysts ranged from 20 to 37,5cm (mean 28,5cm), and they were removed either through the umbilical incision or a colpotomy. The mean surgical time was 85 minutes (60 to 120 minutes) and all procedures were carried out through the laparoscopic approach with no major complications. Conclusion:The laparoscopic approach of giant adnexal cysts is a safe procedure, and should be considered as the first option in patients with low risk of malignancy. Open Communications 17dLaparoscopy(4:32 PM d 4:37 PM)