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Direct trocar insertion without pneumoperitoneum and the Veress needle in laparoscopic cholecystectomy : a
E Prieto-Díaz-Chávez1, J L Medina-Chávez, A González-Ojeda
1Department of Surgery and Unit of Clinical Epidemiology Research, Hospital General de Zona y Medicina Familiar n 1, Colima, México.
Purpose:
The purpose of this study is to compare the safety and complications of direct trocar insertion without pneumoperitoneum (DTI) with Veress needle (VN) in laparoscopic cholecystectomy (LC).
Methods:
We studied 84 patients admitted to our hospital for LC, in a random simple blind design, 42 patients were assigned to DTI and 42 to VN. The variables analysed were : procedure complications, laparoscope insertion time and duration of surgery.
Results:
Complication percentages between the groups were significantly different (DTI 2.3% versus VN 23.8%, p = 0.009). The duration of surgery between the two groups was also significantly different (DTI 56+/-31 versus VN 71+/-28 minutes, p < 0.02). Finally, laparoscope insertion time between the two techniques was significantly different (DTI 1.5+/-0.5 versus VN 3.0+/-0.4 minutes p < 0.001).
Conclusions:
Our results show DTI to be a safe, efficient, rapid and easily-learned alternative technique, reducing the number of procedure-related complications.
