A Comparative Study Between Direct Trocar, Veress Needle And Open Approach Entry In Laparoscopic Surgeries

Abstract

Purpose :The purpose of this study is to compare the results obtained from three laparoscopic techniques , Direct Trocar entry, Veress Needle, and Open Approach (Hassons technique) and to see which is the best method of establishing pneumoperitoneum. Methods :We studied 288 patients admitted to our hospital for laparoscopic surgeries, in a randomised prospective design, 96 patients were assigned each to Direct trocar (DTI), Veress needle(VN) and Open Hassons Approach(OA).The variables analysed were : Mean trocar insertion time, Gas leak, Subcutaneous emphysema and Intra abdominal injuries. Results :Mean trocar insertion time DTI, VN and OA are 77.6±22.4, 180.1±39.8 and 350±127.9 sec,p = <0.001 (Sig), gas leak in 0 (0%), 11(11%) and 39(40.6%) p =<0.001 (Sig),subcutaneous emphysema in 0 (0%), 5(5.2%) and 12(12.5%) p=0.001 (Sig),and intra abdominal injuries 0 (0%), 2(2.1%) and 1(1.0%) Conclusions :Our results show DTI to be a safe, efficient, rapid and easily-learned alternative technique, reducing the number of procedure-related complications.