Left Upper Quadrant Approach in Gynecologic Laparoscopic Surgery with Reusable Instruments

Lam, KW; Pun, Ting-Chung

doi:10.1016/s1074-3804(05)60132-6

Cited by 21 publications

(13 citation statements)

References 7 publications

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“…Palmer's point entry using initial Veress needle insufflation has been reported by a number of authors in the form of case series [7][8][9]. In a randomised study, Azevedo and colleagues [10] compared intraumbilical and left hypochondrium Veress entry.…”

Section: Discussionmentioning

confidence: 99%

Direct optical entry through Palmer’s point: a new technique for those at risk of entry-related trauma at laparoscopy

2009

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We present a technique of direct optical entry through Palmer's point (3 cm below the left costal margin in the mid-clavicular line) as an alternative laparoscopic entry method for those gynaecological patients at risk of periumbilical adhesions. This method has been used in 15 patients and allowed the adhesions to be cleared where necessary. We feel that this technique can provide a safe approach to the abdominal cavity and should be considered as another method alongside closed and open umbilical techniques in the laparoscopic gynaecologist's repertoire.

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Section: Discussionmentioning

confidence: 99%

Direct optical entry through Palmer’s point: a new technique for those at risk of entry-related trauma at laparoscopy

2009

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“…Pneumoperitoneum has been described as ''adequate'', ''appropriate'' or ''sufficient,'' established by an arbitrary volume of 1-4 L of CO 2 without regard to intra-abdominal pressure. Final pressures of 10 mmHg [33], 15 mmHg [20,29,34], 14-18 mmHg [35], 20 mmHg [26,36], 25 mmHg [21,27,[36][37][38][39], and 30 mmHg [22,40] have been advocated [8]. To determine the most appropriate pressure Phillips et al measured the vertical depth of pneumoperitoneum at the umbilicus in 43 women undergoing laparoscopy when volume and pressure of insufflated CO 2 varied [37,41].…”

Section: Discussionmentioning

confidence: 99%

Three simple steps during closed laparoscopic entry may minimize major injuries

Vilos

Abu-Rafea

et al. 2008

Surg Endosc

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“…We used and recommended the left upper quadrant approach [3]. We believe this is safer than the more conventional closed technique.…”

Section: Discussionmentioning

confidence: 99%

LAVH after low anterior resection

Pun

2004

Gynecol Surg

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Two patients with a history of low anterior resection of the rectum undergoing laparoscopic-assisted vaginal hysterectomy (LAVH) were reported. The first patient had a low anterior resection with transverse colostomy for carcinoma of the rectum 8 cm from the anal verge in 1999. The colostomy was closed in 2000. LAVH and bilateral salpingo-oophorectomy were performed in 2002 for ovarian cyst. The left upper quadrant was used for entry of the primary port. Adhesiolysis for extensive peritoneal adhesion was performed, but the hysterectomy was uneventful. The second patient had a low anterior resection for carcinoma of the rectum 10 cm from the anal verge in 1997. LAVH was performed in 2003 for adenomyosis of the uterus. The recovery of both patients was uneventful. With attention to preparation and technique, LAVH can be performed safely in patients after anterior resection.

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Left Upper Quadrant Approach in Gynecologic Laparoscopic Surgery with Reusable Instruments

Cited by 21 publications

References 7 publications

Direct optical entry through Palmer’s point: a new technique for those at risk of entry-related trauma at laparoscopy

Direct optical entry through Palmer’s point: a new technique for those at risk of entry-related trauma at laparoscopy

Three simple steps during closed laparoscopic entry may minimize major injuries

LAVH after low anterior resection

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