A comparative study of the open versus closed method of pneumoperitoneum creation in laparoscopic surgery

Abstract

Background: The main challenge facing the laparoscopic surgery is the primary abdominal access, as it is usually a blind procedure and associated with many complications including life threading vascular and visceral injuries. Techniques for the creation of pneumoperitoneum in laparoscopy include the standard technique of insufflation after insertion of the Veress needle (closed method), open laparoscopy (Hasson technique) and many others.Methods: This is observational study conducted in the department of General surgery, PDUMC, Rajkot from September 2018 to September 2020 comprising of 100 cases, 50 cases from each methods. The patients admitted in our department for Laparoscopic surgery was taken up for the study. The Purpose of our study is to assess the practicality of both methods in creation of pneumoperitoneum and to compare both methods with regards to ease of performance and incidence of complications.Results: Average size of incision (p=-5.426) is more in open method, hence more incidence of minor complications like multiple attempts, gas leak at port site and port site bleeding in open method while less duration for creating pneumoperitoneum (p=0) as compared to closed method. While there is no major complications in either groups.Conclusions: Open technique is as good as closed technique, and is good alternative to closed technique.

The relevance of Veress needle overshooting reduction; A Survey among 365 surgeons

“…In an attempt to de ne user requirements better, literature about the insertion procedure was consulted. Studies by Vaishnani et [14,15]. However, Azevedo et al, reported that insertion at the midline should be avoided as the risks related to overshooting in organs is too high [16].…”

The relevance of reducing Veress needle overshooting

“…In an attempt to define user requirements better, literature about the insertion procedure was reviewed. Studies by Vaishnani et al and Datey et al indicate that there are no significantly different outcomes when open and closed techniques are compared in a more generic way 14 , 15 . However, Azevedo et al, reported that insertion at the midline should be avoided as the risks related to overshooting in organs is too high 16 .…”

Comparison of Two Entry Methods and Their Cosmetic Outcomes in Creating Pneumoperitoneum: A Prospective Observational Study

“…3 Compared with traditional laparotomy (open surgery), laparoscopic technique (closed surgery) has several advantages such as larger field of surgery, minimal traumatic insult, quick postoperative recovery, reduced overall risk and hospitalization time, reduced postsurgical pain and associated stress, cost-effectiveness, and improved cosmetic outcomes. [3][4][5][6][7] Despite technical advancement in laparoscopic procedures, entry and establishment of pneumoperitoneum are…”

“…In this study, to know such procedural cosmetic outcomes of two such main surgical techniques that are widely used in achieving better pneumoperitoneum, HT and VNT were studied and discussed in detail. 1,[3][4][5][6][7]9,11,14,[18][19][20][21] We have also compared and evaluated the cosmetic outcome of primary port insertion at the umbilicus in both the techniques.…”