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[Our choice of the method to induce pneumoperitoneum in videolaparoscopic surgery]
N Gullà1, A Patriti, F Lazzarini
1Dipartimento di Scienze Chirurgiche, Università degli Studi, Perugia.
Background:
In laparoscopic surgery, pneumoperitoneum may be obtained either by a blind or an open access technique. These two techniques and the advantages of Hasson technique are compared.
Methods:
Through January 1998 and May 1999, 262 unselected patients underwent laparoscopic surgery; pneumoperitoneum was obtained with a random technique, while in the patients previously operated on the open technique was always performed. In 161 cases (61.5%) pneumoperitoneum was obtained with Hasson technique and in 101 (38.5%) with Veress technique. All the patients were clinically evaluated after surgery and then after 30-40 days. The complications encountered were always associated with the Veress needle blind access: peritoneal space insufflation in 3 cases, greater omentum insufflation in 3 cases, 4 cases of difficult management and only one case of incisional hernia on the umbilical wound.
Results:
Our data confirm that Hasson open technique is safer than Veress blind technique as the risk of severe early and late complications is lower.
Conclusions:
The open laparoscopic technique with the Hasson trocar is recommended as it showed to be a quicker, safer and superior technique for obtaining pneumoperitoneum.
