Introducción: dentro de las cirugías laparoscópicas, se ha estimado una incidencia de lesión intestinal al momento del acceso de 0.5% y de lesiones a vasos sanguíneos importantes de 1%. Los beneficios teóricos del trócar óptico, incluyen el reconocimiento temprano de lesiones, bajo el supuesto de una mejor visibilidad. Objetivo: determinar si el trócar óptico es un método de acceso laparoscópico más seguro comparado contra trócar directo, aguja de Veress y técnica abierta-Hasson. Material y métodos: cohorte observacional, prospectiva, de cuatro brazos, de mujeres del Servicio de Ginecología y Cirugía Laparoscópica del Hospital Angeles Pedregal. Se cuantificó el número de intentos y tiempo para lograr el acceso a cavidad, así como la presencia de complicaciones. Resultados: se observaron 192 cirugías laparoscópicas, distribuidas por casos consecutivos en cuatro brazos: (90 Veress, 13 Hasson, 14 trócar directo y 75 óptico). Trócar óptico demostró ventaja tanto en el tiempo de acceso como en la frecuencia de complicaciones. El número de intentos para entrar a cavidad fue similar al de la técnica abierta. Conclusión: los datos obtenidos en este estudio orientan a apoyar la técnica de acceso a cavidad con trócar óptico, como un método más seguro que las otras técnicas.

Objective: Compare quality of life in two group of patients with endometriosis Material and methods: Observational, analytical and cross-sectional study. We included 60 women between 20-40 years with endometriosis who underwent surgical and pharmacological treatment with two different schemes, at Angeles Pedregal Hospital from 2019-2022. Group A was treated with peritonectomy + progestin (desogestrel 0.075 mg orally every 24 h) for 3 months, and group B with electrofulguration + GnRH agonist (leuprorelin 3.75 mg intramuscularly every 28 days) for 3 months. EHP-5 was applied prior and 6 months after treatment. Results: When comparing scores before and after treatment in the overall series of patients, both groups signicantly improved all items of EHP-5. Conclusions: Both groups had an improvement in quality of life at 6 months of follow-up

Background: Laparoscopic surgery is a surgical procedure by which access to the abdomino-pelvic cavity is obtained through small incisions. The incidence of bowel injury is estimated at 0.5% and of injury to major blood vessels (iliac, aorta, cava) at the time of access at 1%. Theoretical benets of optical trocar access include immediate and/or early recognition of injury, as well as failed entry, on the assumption that the layers of the abdominal wall are observed with the optical trocar until access has been achieved. To determine whether the optical trocar is a saferObjective: laparoscopic access method compared to the other techniques with direct trocar, Veress needle and Hasson open technique. Material and Methods: Observational, analytical, prospective cohort study with four arms. The study included women over 18 years of age who attended the gynaecology and laparoscopic surgery department of the Hospital Ángeles del Pedregal. The number of attempts and access time, as well as the presence of complications were quantied. Results and Conclusions: Trocar access had an advantage over the other techniques, both in access time and lower incidence of complications. The number of attempts to enter the cavity was similar to the open technique. We can conclude that the optical trocar technique is safer than the other techniques even over the open technique (Hasson).