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Related Experiment Videos

High-pressure trocar insertion technique.

H Reich1, S C Ribeiro, C Rasmussen

  • 1Division of Advanced Laparoscopic Surgery, College of Physicians & Surgeons of Columbia University, New York, New York 10032, USA.

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|May 14, 1999
PubMed
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This study introduces a high-pressure abdominal entry technique for laparoscopic trocar insertion, significantly reducing injuries. This method enhances patient safety during laparoscopic procedures without needing extra tools or training.

Area of Science:

  • Minimally Invasive Surgery
  • Surgical Techniques
  • Laparoscopic Surgery

Background:

  • Laparoscopic complications frequently occur during Veress needle and trocar insertion.
  • These complications increase patient morbidity and mortality.
  • Existing alternative trocar insertion techniques have not fully eliminated injury risks.

Purpose of the Study:

  • To present a novel high-pressure abdominal entry technique for laparoscopic trocar insertion.
  • To evaluate the safety and efficacy of this technique in reducing trocar-related injuries.

Main Methods:

  • A specific trocar insertion method was employed after Veress needle insertion and pneumoperitoneum establishment (25-30 mm Hg).
  • The technique involves inserting a short trocar into the umbilicus's deepest part without lifting the abdominal wall, creating a direct parietal peritoneal puncture.

Related Experiment Videos

  • High-pressure settings were reduced post-safe abdominal entry.

    • Main Results:

    • The technique was successfully applied in 3041 procedures.
    • No vascular injuries were reported.
    • Two cases of bowel perforation occurred, and no complications linked to elevated intra-abdominal pressure were observed.

    Conclusions:

    • The high-pressure abdominal entry technique effectively minimizes intra-abdominal trocar-related injuries.
    • This method offers an advantage by not requiring additional instrumentation or specialized training.
    • It presents a safer approach to laparoscopic trocar insertion.