Open <i>versus</i>
 closed establishment of pneumoperitoneum in laparoscopic surgery

Bonjer, H. J.; Hazebroek, Eric J.; Kazemier, Geert; Giuffrida, Maria Carmela; Meijer, W. S.; Lange, Johan F.

doi:10.1046/j.1365-2168.1997.d01-1355.x

Cited by 201 publications

(254 citation statements)

References 12 publications

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“…The closed technique using the Veress needle-which is believed to be less time-consuming, less invasive, and better at preventing gas leakage at the first trocar entry site-is preferred by the majority of surgeons [3]. However, at least two comparative studies have failed to show any timesaving advantages for closed laparoscopy, and in experi- enced hands, the leakage of carbon dioxide can be prevented by using a careful dissection technique [2,16].…”

Section: Discussionmentioning

confidence: 99%

“…At least three different techniques are currently used to obtain laparoscopic access to the abdominal cavity. However, none of them entirely obviate the possibility of intraoperative complications caused by trocars and needles [3,8]. The closed technique is probably the most widely used method.…”

Section: Discussionmentioning

confidence: 99%

“…The open (Hasson) technique has been reported to be safer and is therefore increasingly favored by many surgeons [10]. However, even blunt introduction of the first trocar under direct vision cannot fully prevent every iatrogenic injury [3,8,17]. According to reports in the literature, the incidence of trocar and needle injuries is low, ranging from 0.03% to 0.2%; however, these complications may be underreported, and the true incidence may be even higher [3,5,6,9,11,17].…”

mentioning

confidence: 99%

“…The set-up phase of laparoscopy with the establishment of the pneumoperitoneum and creation of the working space is associated with the danger of perforating injuries caused by trocars and the spring-loaded (Veress) needle [3]. In particular, blind insertions of the Veress needle and/or the first trocar near the umbilicus are related to the inadvertent perforation of vessels and parenchymatous and hollow viscus organs.…”

mentioning

confidence: 99%

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Trocar and Veress needle injuries during laparoscopy

Lauper²,

2001

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Background: Inadvertent lesions of the intraabdominal organs and vessels caused by trocars and Veress needles are rare but serious complications of laparoscopic surgery. Establishing the pneumoperitoneum is believed to be the most dangerous step. Methods: The Swiss Association for Laparoscopic and Thoracoscopic Surgery (SALTS) prospectively collected the data on 14,243 patients undergoing various standard laparoscopic procedures between 1995 and 1997. This database was investigated with special regard to intraabdominal complications caused by trocars and Veress needles. Results: There were 22 trocar and four needle injuries (incidence, 0.18%). Nineteen lesions involved visceral organs; the remaining seven were vessel injuries. The small bowel was the single most affected organ (six cases), followed by the large bowel and the liver (three cases each). All vascular lesions, except for one laceration of the right iliac artery, occurred as venous bleeding of either the greater omentum or the mesentery. Fourteen trocars were inserted under direct vision. Nineteen trocar injuries were recognized intraoperatively; diagnoses of two small bowel and one bladder injuries were made postoperatively. Needle injuries were all diagnosed intraoperatively. Only five injuries could be repaired laparoscopically; the remaining lesions were repaired openly. Four patients underwent an open reoperation, and another patient needed five reoperations. There was one death (4.0%). Conclusions: Trocar and needle injuries are rare complications of laparoscopy. However, if not recognized intraoperatively and repaired immediately, they induce increased morbidity and mortality. Both open and closed establishment of the pneumoperitoneum are related to a potential danger of perforating lesions, but inserting the first trocar under direct vision allows early recognition and immediate repair.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Trocar and Veress needle injuries during laparoscopy

Lauper²,

2001

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“…Alternatively, retractor and tissue holding forceps are utilised. Ligation lexcision is carried out by Pomeroy's, Uchida"s Irvings or Kroener's technique [4]. The procedure results in damage to about 4 to 5 em of tubal length and a prominent abdominal scar.…”

Section: Techniques In Practicementioning

confidence: 99%

Cosmetic Scar and Scope of Reversal After Puerperal Sterilisation

Rath

Chattopadhyaya

Tarneja

2000

Medical Journal Armed Forces India

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Female sterilisation is an important component of National Family Welfare Programme. The target group is best motivated during the puerperium for such a procedure. However laparoscopic sterilisation which has got some distinct advantages, is not technically feasible at this time. The authors have used a technique where the advantages of cosmetic appearance, reduced post operative morbidity and reversibility can be conferred on the puerperal women.After trying out the method individually in some cases, a formal case control study design has been made and an evaluation study has been performed in 122 cases. The technique has been found to be cosmetically more acceptable, both at clientele and peer evaluation levels (p

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Complications of laparoscopic surgery

Osman¹

2015

Gastrointestinal Emergencies

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Open versus closed establishment of pneumoperitoneum in laparoscopic surgery

Abstract: Open establishment of pneumoperitoneum is advocated in laparoscopic surgery because it is safer than the closed method.

Cited by 201 publications

References 12 publications

Trocar and Veress needle injuries during laparoscopy

Trocar and Veress needle injuries during laparoscopy

Cosmetic Scar and Scope of Reversal After Puerperal Sterilisation

Complications of laparoscopic surgery

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