Laparoscopic entry after previous surgery

Frappell, Jonathan

doi:10.1111/j.1744-4667.2012.00119.x

Cited by 3 publications

(3 citation statements)

References 3 publications

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“…However, this site is not appropriate for some patients because of previous laparotomy, ventral hernia, suspected intraperitoneal adhesions, or failure of access after three attempts. In these patients, there are other sites for entry, with Palmer’s point being the most commonly recommended site .…”

Section: Discussionmentioning

confidence: 99%

Latif’s point: A new point for Veress needle insertion for pneumoperitoneum in difficult laparoscopy

Ellatif

Ghnnam

Abbas

et al. 2017

Asian J Endoscop Surgery

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Section: Discussionmentioning

confidence: 99%

Latif’s point: A new point for Veress needle insertion for pneumoperitoneum in difficult laparoscopy

Ellatif

Ghnnam

Abbas

et al. 2017

Asian J Endoscop Surgery

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“…Hence, the precise position of Palmer's point for any individual surgeon may vary from the original description of 3 cm below the costal margin. In Audebert and Gomel's series of over 800 patients, in three cases with previous surgery in the left upper quadrant they safely inserted the Veress needle via a right subcostal approach …”

Section: Author's Replymentioning

confidence: 99%

“…It is a great pity that Jonathan Frappell did not take the opportunity in his otherwise excellent overview to recommend that laparoscopic entry in any women with a history of a lower abdominal laparotomy, be it a low transverse or vertical incision, should be via Palmer's point . In failing to do so, he perpetuated the indecisive line taken in the RCOG guideline on Preventing Entry‐related Gynaecological Laparoscopic Injuries he refers to, and which states: “The umbilicus may not, therefore, be the most appropriate site for primary trocar insertion following previous abdominal surgery” .…”

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confidence: 99%

Laparoscopic entry after previous surgery

Magos

Frappell

2013

The Obstetric & Gynaecologis

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A Relook into Visceral Slide Test as a Preoperative Screening Modality to Detect Abdominal Wall Adhesions: A Prospective Observational Cohort Study

Himanshi

Roopa

Rao

et al. 2022

CWHR

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Background: Background: Ultrasound has become an invaluable tool in our daily practice. Its role in screening for adhesions has been tested since the 1990s. Objective: This study aims to determine the role of the visceral slide test as a screening method to predict abdominal wall adhesions in women undergoing gynecological surgery. Methods: We conducted a prospective observational cohort study from August 2017 to July 2019 in women undergoing elective abdominopelvic surgery for a gynecological indication. Preoperatively, a visceral slide test was performed in 5 specified zones on the abdomen and the test results were clinically correlated with the presence, severity, and extent of adhesions intra-operatively. Results: Results were reported as mean, standard deviation, range of values or number and percentage. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy (including 95% confidence interval for all) of visceral slide test were calculated to determine intra-abdominal adhesions . We also found a correlation between the number of negative slide tests and PAI scores using Spearman’s correlation test. Of the 339 women who completed the study, 41.2% had a previous history of abdominopelvic surgery. In this study, the visceral slide test was found to have a sensitivity of 70.87% ( 95%CI 62.15-78.59), specificity of 86.32% (95% CI 80.95-90.64), positive predictive value (PPV) of 75.63% ( 95% CI 68.49-81.59), negative predictive value (NPV) of 83.18%( 95% CI 78.95-86.70) and diagnostic accuracy of 80.53%( 95% CI 75.91-84.61)with p-value less than 0.001. The number of negative slide tests positively correlated with the Peritoneal Adhesion Index score (r = 0.662, p < 0.001) and also with increasing operative time and intraoperative blood loss. Accuracy and positive predictive value of the test were significantly higher in patients with a history of abdominal surgeries, endometriosis and PID. Conclusion: Visceral slide test is an easy, rapid, non-invasive and reliable screening test to predict abdominal adhesions in women undergoing gynecological surgery. The presence of risk factors for adhesions increases the accuracy of the test.

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Laparoscopic entry after previous surgery

Cited by 3 publications

References 3 publications

Latif’s point: A new point for Veress needle insertion for pneumoperitoneum in difficult laparoscopy

Latif’s point: A new point for Veress needle insertion for pneumoperitoneum in difficult laparoscopy

Laparoscopic entry after previous surgery

A Relook into Visceral Slide Test as a Preoperative Screening Modality to Detect Abdominal Wall Adhesions: A Prospective Observational Cohort Study

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