RETIRED: No. 193-Laparoscopic Entry: A Review of Techniques, Technologies, and Complications

Vilos, George A.; Ternamian, Artin; Dempster, Jeffrey; Laberge, Philippe Y.

doi:10.1016/j.jogc.2017.04.013

Cited by 31 publications

(27 citation statements)

References 80 publications

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“…This is mainly due to the expansion of the thick fatty layer of the abdominal wall, with translocation of the umbilicus to a more caudal position than the normal umbilical site. Studies have demonstrated the position of the umbilicus as being on average 0.4, 2.4 and 2.9 cm caudally to the aortic bifurcation in normal-weight (BMI < 25 kg/m 2 ), overweight (BMI 25e30 kg/m 2 ) and obese women (BMI > 30 kg/m 2 ) [26]. The umbilicus was cephalad in all cases to where the left common iliac vein crossed the midline at the sacral promontory [26].…”

Section: Entry Techniques In Obese Patientsmentioning

confidence: 98%

“…Studies have demonstrated the position of the umbilicus as being on average 0.4, 2.4 and 2.9 cm caudally to the aortic bifurcation in normal-weight (BMI < 25 kg/m 2 ), overweight (BMI 25e30 kg/m 2 ) and obese women (BMI > 30 kg/m 2 ) [26]. The umbilicus was cephalad in all cases to where the left common iliac vein crossed the midline at the sacral promontory [26]. Although the umbilicus may be displaced caudally, the location of intra-abdominal blood vessels remains constant.…”

Section: Entry Techniques In Obese Patientsmentioning

confidence: 99%

See 1 more Smart Citation

Obesity in laparoscopic surgery

Afors

Centini

Murtada

et al. 2015

Best Practice & Research Clinical Obstetrics & Gynaecol

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Section: Entry Techniques In Obese Patientsmentioning

confidence: 98%

Section: Entry Techniques In Obese Patientsmentioning

confidence: 99%

Obesity in laparoscopic surgery

Afors

Centini

Murtada

et al. 2015

Best Practice & Research Clinical Obstetrics & Gynaecol

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“…There is still no consensus in the human literature regarding the optimal approach to establish the initial pneumoperitoneum and placement of the primary port. Multiple clinical trials and meta‐analyses have been conducted in human surgery, and there is no evidence that one particular entry technique is superior to another . A search of PubMed (Entry technique, Laparoscopy) for laparoscopic entry techniques from 1990 until the present revealed at least 171 published articles, showing the importance of the problem in human laparoscopy.…”

Section: Introductionmentioning

confidence: 99%

“…Finally, the single‐access port through a minilaparotomy without initial insufflation has been described. The choice among those techniques is mostly based on surgeon preferences, training, and surgical experience …”

Section: Introductionmentioning

confidence: 99%

Laparoscopic entry techniques: What is the controversy?

Monnet

2019

Veterinary Surgery

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Objective: To review reported complications related to the different laparoscopic entry techniques in the human and veterinary literature and describe the benefits and limitations of each technique. Study design: Literature review of 57 peer-reviewed articles. Methods: An electronic database search identified human and veterinary literature describing complications related to entry technique during laparoscopy. Results: Open-and closed-entry techniques may result in trauma of abdominal organs or vasculature. During laparoscopy in man, injury to bowel and major vasculature is reported in 0.02% and 0.04% of procedures with open-or closed-entry techniques, respectively. Designs of Veress needles and trocar cannula assemblies have been developed to improve ease and safety. Early complications, defined as those observed at the time of port entry into the abdominal cavity, result from the puncture of a blood vessel leading to substantial visible hemorrhage. Late complications are detected 24 or 48 hours after surgery and result from the puncture of a loop of intestine that was not detected at the time of initial surgery. The major reasons for iatrogenic trauma in man are related to anatomical factors and the presence of adhesions. No explanation for cause of complications was identified for animals. Conclusion: There is no consensus in the human or veterinary literature about the best entry technique for laparoscopy. The rate of complications related to entry technique in small animals is not known because the data are underreported. Clinical significance: Complications related to entry techniques are expected in both man and animals. Improvements in techniques and equipment design are being developed to minimize risk.

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“…A 5 mm optical port was used in the supraumbilical area to gain entry into the abdomen (Video ). After the cannula was removed, an exploration was attempted, but proper insufflation of the cavity was not achieved and it was not possible to identify any structures . Decision was made to remove the trocar and repeat the procedure, accomplishing a proper insufflation and access to the peritoneal cavity.…”

mentioning

confidence: 99%