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Related Concept Videos

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...

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Related Experiment Video

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Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
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Three simple steps during closed laparoscopic entry may minimize major injuries.

George A Vilos1, Angelos G Vilos, Basim Abu-Rafea

  • 1Department of Obstetrics and Gynecology, St. Joseph's Health Care, The University of Western Ontario, 268 Grosvenor St., London, ON, Canada N6A 4V2. george.vilos@sjhc.london.on.ca

Surgical Endoscopy
|July 16, 2008
PubMed
Summary

Initial Veress needle pressure (VIP-Pressure) below 10 mmHg confirms correct placement. Transient high-pressure pneumoperitoneum (HIP-Entry) and visual entry with a trocarless cannula are safe and effective techniques for reducing laparoscopic entry injuries.

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Technology
  • Gynecologic Laparoscopy

Background:

  • Laparoscopic entry is associated with significant risks of major injuries.
  • Current entry techniques require careful needle placement and insufflation.
  • Novel methods are needed to improve the safety of closed laparoscopic entry.

Purpose of the Study:

  • To evaluate three techniques for closed laparoscopic entry: initial Veress pressure (VIP-Pressure), transient high-pressure pneumoperitoneum (HIP-Entry), and visual entry with a trocarless cannula.
  • To assess the safety and efficacy of these methods in reducing major injuries.
  • To correlate initial Veress pressure with patient characteristics.

Main Methods:

  • Prospective observational cohort study at a university-affiliated teaching hospital.
  • VIP-Pressure measured during Veress needle insertion in 365 women, correlated with body habitus and parity.
  • HIP-Entry performed in 2,498 cases with cardiopulmonary monitoring.
  • Visual entry with a trocarless cannula used in 776 cases.

Main Results:

  • VIP-Pressure <10 mmHg indicated correct Veress needle placement.
  • HIP-Entry to 25-30 mmHg showed no adverse cardiovascular effects and minimal, clinically insignificant changes in pulmonary compliance.
  • No injuries were reported with the visual entry trocarless cannula in 776 cases.

Conclusions:

  • A VIP-Pressure below 10 mmHg reliably indicates intraperitoneal placement.
  • Transient HIP-Entry is safe for cardiopulmonary function in healthy women.
  • Visual entry with a trocarless cannula provides an additional safety measure for laparoscopic entry.