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Related Experiment Videos

Umbilical stalk technique for establishing pneumoperitoneum.

Alfredo M Carbonell1, Kristi L Harold, Trina I Smith

  • 1Department of General Surgery, Carolinas Medical Center, Carolinas Laparoscopic and Advanced Surgery Program, Charlotte, North Carolina 28203, USA.

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|August 20, 2002
PubMed
Summary

This study introduces a mini-open umbilical stalk technique for safe and rapid laparoscopic abdominal access. This method avoids complications associated with Veress needle and Hasson techniques, offering a faster procedure.

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Techniques
  • Laparoscopic Access

Background:

  • The Veress needle technique for pneumoperitoneum is common but linked to slow insufflation and serious complications.
  • The open (Hasson) technique is safer but often perceived as cumbersome.
  • Existing methods present challenges in speed, safety, or ease of use for laparoscopic entry.

Purpose of the Study:

  • To describe and evaluate a novel mini-open umbilical stalk technique for laparoscopic abdominal access.
  • To demonstrate the safety, speed, and efficacy of this technique in a large patient cohort.
  • To offer an alternative to traditional methods for establishing pneumoperitoneum.

Main Methods:

  • A mini-open technique utilizing a 5-mm transumbilical incision without a trocar.

Related Experiment Videos

  • Placement of a 5-mm blunt cannula through the umbilical stalk.
  • Application of the technique in 600 patients over a 4-year period for various laparoscopic procedures.

    • Main Results:

    • The technique was successfully employed in 600 patients over 4 years without any reported complications.
    • Abdominal access was achieved safely and rapidly, with procedure start times typically under 2 minutes from skin incision.
    • Eliminated the need for midline laparotomy incisions incorporating the umbilicus and stay sutures.

    Conclusions:

    • The mini-open umbilical stalk technique provides rapid, safe, and effective abdominal access for laparoscopy.
    • This method mitigates risks associated with blind needle or trocar insertions and avoids larger incisions.
    • It is recommended as a simple and advantageous entry technique for uncomplicated abdominal laparoscopy.