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Open laparoscopic access using a radially dilating trocar: experience and indications in 50 consecutive cases
D C Cuellar1, P K Kavoussi, L A Baker
1Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, Maryland, USA.
Background:
Laparoscopy can be performed using needle access for initial insufflation or open access.
Patients And Methods:
A technique for open laparoscopic access to the abdomen using a radially dilating cannula was used in 52 operations in 50 patients. Indications included age <2 years, severe kyphosis, and creation of an umbilical stoma.
Results:
There was one case of minor leakage of carbon dioxide that did not affect the procedure being performed. There were two cases of preperitoneal placement, which were recognized immediately; in both, peritoneal access was easily obtained.
Conclusion:
Open laparoscopic access is safely and easily performed with a radially dilating trocar. This is the preferred technique at our institution for patients who meet the criteria for open access.