Melgoza OC, Lasky MD, Hesiquio SR, Ruiz-Velasco RC, Hidalgo CF

Language: Spanish
References: 22
Page: 41-43
PDF size: 37.82 Kb.

ABSTRACT

Objective: To review the efficacy and safety of the direct insertion of the first trocar without previous pneumoperitoneum.
Setting: Third level health care hospital.
Design: Prospective, observational study, without control group.
Patients and method: In a seven year period, a total of 350 patients were operated laparoscopically; direct insertion of the first trocar without previous pneumoperitoneum was performed in all of them, without selecting the patients nor excluding any patient due to previous surgery.
Results: No complications occurred related to the insertion technique, time to create the pneumoperitoneum was brief-15 seconds-using a 20 l/min insufflator.
Conclusion: The technique of creating a pneumoperitoneum without the Veress needle is simple, safe, and decreases complications.

REFERENCES

1. León LG, Melgoza OC. Cirugía de invasión mínima. Cir Gen 1996; 18: 301-2.

2. Melgoza OC, Hesiquio SR, Lasky MD, Schenk PL, Hidalgo CF. Funduplicatura laparoscópica con trócares de 5 mm. ¿Evita las hernias postincisionales? Cir Gen 2001; 23: 33-5.

3. Kaali SG, Bartai G. Direct Insertion of the laparoscopic trocar after an earlier laparotomy. J Reprod Med 1988; 33: 739-40.

4. Copeland C, Wing R, Hulka JF. Direct trocar insertion at laparoscopy: an evaluation. Obstet Gynecol 1983; 62: 655-9.

5. Olvera PD, Gómez MJR, Gudiño MJ. Técnica de inserción directa del primer trócar sin neumoperitoneo. Cir Gen 1998; 20: 136-8.

6. Borgatta L, Gruss L, Barad D, Kaali SG. Direct trocar insertion vs Veress needle use for laparoscopic sterilization. J Reprod Med 1990; 35: 891-4.

7. Saidi MH. Direct laparoscopy without prior pneumoperitoneum. J Reprod Med 1986; 31: 684-6.

8. Jarrett JC 2nd. Laparoscopy: direct trocar insertion without pneumoperitoneum. Obstet Gynecol 1990; 75: 725-7.

9. Nezhat FR, Silfen SL, Evans D, Nezhat C. Comparison of direct insertion of disposable and standard reusable laparoscopic trocars and previous pneumoperitoneum with Veress needle. Obstet Gynecol 1991; 78: 148-50.

10. Baadsgaard SE, Bille S, Egeblad K. Major vascular injury during gynecologic laparoscopy. Report of a case and review of published cases. Acta Obstet Gynecol Scand 1989; 68: 283-5.

11. Rosen DM, Lam AM, Chapman M, Carlton M, Cario GM. Methods of creating pneumoperitoneum: A review of techniques and complications. Obstet Gynecol Surv 1998; 53: 167-74.

12. Querleu D, Chevallier L, Chapron C, Bruhat MA. Complications of gynecological laparoscopic surgery. A French Multicentre Collaborative Study. Gynaecol Endosc 1993; 2: 3-6.

13. Mintz M. Risks and prophylaxis in laparoscopy: a survey of 100,000 cases. J Reprod Med 1977; 18: 269-72.

14. Yerdel MA, Karayalcin K, Koyuncu A, Akin B, Koksoy C, Turkcapar AG, et al. Direct trocar insertion versus Veress needle insertion in laparoscopic cholecystectomy. Am J Surg 1999; 177: 247-9.

15. Byron JW, Markenson G, Miyazawa K. A randomized comparison of Veress needle and direct trocar insertion for laparoscopy. Surg Gynecol Obstet 1993; 177: 259-62.

16. Hasson HM. A modified instrument and method for laparoscopy. Am J Obstet Gynecol 1971; 110: 886-7.

17. Woolcott R. The safety of laparoscopy performed by direct trocar insertion and carbon dioxide insufflation under vision. Aust N Z J Obstet Gynaecol 1997; 37: 216-19.

18. Mettler L, Ibrahim M, Vinh VQ, Jonat W. Clinical experience with an optical access trocar in gynecological laparoscopy-pelviscopy. J Soc Laparosc Surg 1997; 1:315-8.

19. Kaali SG, Barad DH, Merkatz IR. Comparison of visual and tactile localization of the trocar tip during abdominal entry. J Am Assoc Gynecol Laparosc 1994; 2: 75-7.

20. Wolf JS Jr. Laparoscopic access with a visualizing trocar. Tech Urol 1997; 3: 34-37.

21. Bhoyrul S, Vierra MA, Nezhat CR, Krummel TM, Way LW. Trocar injuries in laparoscopic surgery. J Am Coll Surg 2001; 192: 677-83.

22. Chandler JG, Corson SL, Way LW. Three spectra of laparoscopic entry access injuries. J Am Coll Surg 2001; 192: 478-90; discussion 490-1.