Comparativa entre 2 técnicas de insuflación laparoscópica cerrada con aguja de Veress. Estudio prospectivo multicéntrico de 300 casos

Garrido, Manuel; Sánchez, Zoraida Frías; Novo, Sara Rojo; Serrano, Mayor; Rosso, François

doi:10.1016/j.gine.2019.01.002

Cited by 1 publication

(4 citation statements)

References 18 publications

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“…With similar results, several authors have studied and analyzed safety mechanisms that could reduce these entry complications. 5 These security maneuvers could help to reduce the morbidity and mortality during the access in laparoscopy. 17 Nevertheless, there is no general consensus in terms of safety, based on published scientific evidence.…”

Section: Discussionmentioning

confidence: 99%

“…These complications include those related with the access to the abdominal cavity and the creation of the pneumoperitoneum, such as subcutaneous emphysema, visceral or vascular lesion, abdominal wall hematoma or abdominal herniation through trocar incision. [4][5][6][7] The total complication rate in laparoscopic surgery is 0.2-10.3%, depending on factors such as the body mass index (BMI), previous abdominal surgery, failed entry attempts, the technical difficulty of the surgery or the surgical team experience. 1,5,8 Even though the complication rate is low, up to 40-50% of complications arise during the access to the abdominal cavity or after the insertion of the accessory trocars.…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6][7] The total complication rate in laparoscopic surgery is 0.2-10.3%, depending on factors such as the body mass index (BMI), previous abdominal surgery, failed entry attempts, the technical difficulty of the surgery or the surgical team experience. 1,5,8 Even though the complication rate is low, up to 40-50% of complications arise during the access to the abdominal cavity or after the insertion of the accessory trocars. 5,9 This rate of complications has remained unchanged for the last 25 years, 10 hence, the need for this study.…”

Section: Introductionmentioning

confidence: 99%

“…1,5,8 Even though the complication rate is low, up to 40-50% of complications arise during the access to the abdominal cavity or after the insertion of the accessory trocars. 5,9 This rate of complications has remained unchanged for the last 25 years, 10 hence, the need for this study.…”

Section: Introductionmentioning

confidence: 99%

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Palmer's test usefulness in the correct positioning of the Veress needle and the reduction of complications during laparoscopic access maneuvers

Brenner-Anidjar

Rojo-Novo

Frías-Sánchez

et al. 2020

J of Obstet and Gynaecol

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Aim Abdominal cavity access accounts for 50% of complications during laparoscopic surgery. Different safety maneuvers have been used to try to diminish these. Our study aims to establish the usefulness of Palmer's test in the correct positioning of the Veress needle and the reduction of complications during laparoscopic access maneuvers, when used in addition to the determination of intraabdominal pressure. Methods Prospective observational analytic multi‐centered cohort study with 370 patients undergoing gynecologic laparoscopy between July 2014 and November 2019, comparing the additional use of Palmer's test in 185 patients (Palmer‐Test‐Yes, PTY), with intraabdominal pressure determination alone in 185 patients (Palmer‐Test‐No, PTN). Results Intergroup homogeneity was described for the basic characteristics of both population samples, except for mean age and percentage of previous laparotomy. A total of 19 complications were recorded, 10 in PTY and 9 in PTN, with no significant differences (P = 0.814). No differences were found in the analysis of these complications, except for the rate of conversion to laparotomy, which occurred four times in the PTY group and none in PTN (P = 0.044). Furthermore, no differences were found once fixed for the history of previous laparotomy (P = 514.), nor for the percentage of successful access after the first attempt between both groups (P = 0.753). Conclusion Palmer's test, when used in addition to intraabdominal pressure determination, has not shown to be effective in preventing failed access to abdominal cavity or reducing complications associated with access maneuvers with the Veress needle. Hence, its systematic use is not justified, since it could generate a sense of false security.

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Section: Discussionmentioning

confidence: 99%