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Updated: Jun 23, 2026

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Initial laparoscopic access in postmenopausal women: a preliminary prospective study.

Andrea Tinelli1, Antonio Malvasi, Marcello Guido

  • 1Department of Obstetrics and Gynaecology, Vito Fazzi Hospital, Lecce, Italy. andreatinelli@gmail.com

Menopause (New York, N.Y.)
|April 25, 2009
PubMed
Summary

Direct optical access (DOA) is a faster and safer laparoscopic entry method for postmenopausal women compared to the Veress needle approach. This technique reduces minor vascular injuries and speeds up abdominal entry.

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Area of Science:

  • Minimally Invasive Surgery
  • Gynecologic Surgery
  • Laparoscopic Access Techniques

Background:

  • Menopause-induced estrogen loss leads to skin atrophy, affecting surgical outcomes.
  • Laparoscopic surgery complications often occur during initial abdominal entry.
  • Evaluating safe and efficient laparoscopic access is crucial for postmenopausal women.

Purpose of the Study:

  • To compare the efficacy and safety of direct optical access (DOA) versus the Veress needle technique for laparoscopic entry in postmenopausal women.
  • To assess operative time, vascular/bowel injury rates, and blood loss between the two methods.

Main Methods:

  • A comparative study of 186 postmenopausal women undergoing laparoscopic surgery for ovarian cysts.
  • Group I (n=89) used direct optical access (DOA); Group II (n=97) used the Veress needle approach.

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  • Key parameters: abdominal entry time, major/minor vascular and bowel injuries, and blood loss.

    • Main Results:

    • No significant difference in major vascular or bowel injuries between DOA and Veress needle techniques (P > 0.05).
    • DOA significantly reduced abdominal entry time compared to the Veress needle approach (P < 0.05).
    • DOA also showed a significant reduction in minor vascular injuries (P < 0.05).

    Conclusions:

    • Direct optical access (DOA) offers a statistically significant advantage over the Veress needle approach for laparoscopic entry in postmenopausal women.
    • DOA enables faster, safer visually guided entry, reducing operative time and minor vascular complications.
    • This visual entry system is a promising alternative for gynecologists performing laparoscopic procedures.