Initial laparoscopic access in postmenopausal women

Abstract

Results of this preliminary comparison on the DOA and the Veress methods, commonly used by gynecologists, suggest that the visual entry system offers a statistical advantage over the closed Veress needle approach, in terms of time saving and limiting minor vascular injuries, thus enabling a safe and fast visually guided entry in postmenopausal women.

Bladeless Direct Optical Trocar Insertion in Laparoscopic Procedures on the Obese Patient

“…8 In some instances, our results agreed with the results of comparative studies of DOE and VNE in reproductive-age women without previous surgery 6 and in postmenopausal women. 7 Furthermore, our results concurred with entry times by other teams 14 who applied DOE as an alternative to VNE in 650 laparoscopic procedures and who analyzed the site, the duration of entry, and any complications. String et al 14 demonstrated varied mean entry times in seconds with SD values depending on the trocar entry sites: 114 ± 30 at the back site, 92 ± 45 at the umbilical site, and 77 ± 35 at remaining sites, including right/left/midline upper and right/left lower quadrants, with 2 serious complications such as small-bowel and gallbladder injuries.…”

“…Over the years, we have been researching abdominal entry with comparative studies of direct optical entry (DOE) using a bladeless trocar versus a blind closed access by Veress needle entry (VNE) in young women without previous surgery, 6 in postmenopausal women, 7 as well as comparison of DOE with open laparoscopy by open Hasson technique (OHT) in women with previous abdominopelvic surgery. 8 …”

“…6 Likewise in postmenopausal women, time for abdominal entry was significantly reduced in the DOA group (65.7 ± 11.9 vs 192.8 ± 5.6 seconds) compared with that of the VNE group in the absence of significant differences concerning blood loss value (8.4 ± 7.2 vs 9.3 ± 5.5 mL) and minor vascular (1 of 89 vs 3 of 97) and major vascular as well as minor bowel injuries. 7 …”