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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.
Journal of Endourology
|December 8, 2000
Summary
Open laparoscopic access using a radially dilating trocar is a safe and effective method for abdominal insufflation. This technique is preferred for specific patient groups, ensuring ease of use and successful procedures.
Area of Science:
- Minimally Invasive Surgery
- Surgical Access Techniques
Background:
- Laparoscopic surgery requires initial abdominal insufflation.
- Two primary methods for insufflation exist: needle access and open access.
Purpose of the Study:
- To evaluate the safety and efficacy of a radially dilating cannula for open laparoscopic access.
- To determine the suitability of this technique for specific patient populations.
Main Methods:
- A radially dilating cannula technique was employed in 52 operations across 50 patients.
- Indications for this method included pediatric patients (age <2 years), severe kyphosis, and umbilical stoma creation.
Main Results:
- One instance of minor carbon dioxide leakage occurred, without procedural impact.
- Two cases of preperitoneal cannula placement were identified and immediately corrected, allowing easy peritoneal entry.
Conclusions:
- Radially dilating trocar facilitates safe and straightforward open laparoscopic access.
- This technique is the preferred method at our institution for patients meeting open access criteria.