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Abdominal access in gynaecologic laparoscopy: a comparison between direct optical and open access
Andrea Tinelli1, Antonio Malvasi, Gernot Hudelist
1Department of Obstetrics and Gynecology, Vito Fazzi Hospital, Piazza Muratore, Lecce, Italy. andreatinelli@gmail.com
Summary
Direct optical access (DOA) offers a safe, fast, visually guided entry, reducing operative time and blood loss compared to the traditional Hasson technique. This laparoscopic access method shows a slight statistical advantage in preliminary comparisons.
Area of Science:
- Minimally Invasive Surgery
- Surgical Techniques
- Gynecologic Laparoscopy
Background:
- Laparoscopic surgery complications often occur during initial abdominal entry.
- Investigating efficacy and safety of direct optical access (DOA) versus Hasson technique.
Purpose of the Study:
- Compare DOA and Hasson methods for laparoscopic abdominal entry.
- Evaluate safety, duration of access, and blood loss.
Main Methods:
- Prospective randomized trial of 202 premenopausal women undergoing laparoscopic surgery.
- Comparison of open (Hasson) and direct optical access (DOA) techniques.
- Analysis of vascular/bowel injury, access duration, and blood loss.
Main Results:
- No significant difference in major vascular or bowel injury between DOA and Hasson techniques.
- Significantly reduced time for abdominal entry with DOA.
- Significantly reduced blood loss with DOA (P < 0.05).
Conclusions:
- DOA provides a safe, fast, visually guided laparoscopic entry.
- DOA shows a slight statistical advantage over Hasson entry in time saving and blood loss reduction.
- DOA is a viable alternative for laparoscopic abdominal access.
