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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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Updated: May 24, 2026

Laparoscopic-Assisted Seldinger Technique for Peritoneal Dialysis Catheter Insertion
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Laparoscopic entry techniques.

Gaity Ahmad1, Helena O'Flynn, James M N Duffy

  • 1Obstetrics & Gynaecology, Pennine Acute NHS Trust, Manchester, UK. gaityahmad@hotmail.com.

The Cochrane Database of Systematic Reviews
|February 17, 2012
PubMed
Summary
This summary is machine-generated.

Direct-trocar entry and open-entry techniques reduce failed laparoscopic entry compared to Veress Needle, with no increased risk of major injury. These findings offer safer laparoscopic entry options for gynecological and general surgery.

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Techniques
  • Patient Safety

Background:

  • Laparoscopic surgery entry is a common source of complications, including visceral and vascular injury.
  • Optimal laparoscopic entry techniques remain debated, with no clear consensus.
  • This review updates previous findings on laparoscopic entry methods.

Purpose of the Study:

  • To evaluate the benefits and risks of various laparoscopic entry techniques.
  • To compare different methods for accessing the peritoneal cavity during laparoscopy.
  • To identify safer and more effective laparoscopic entry procedures.

Main Methods:

  • Systematic review of 28 randomized controlled trials (RCTs) involving 4860 patients.
  • Searched MEDLINE, EMBASE, CENTRAL, and PsycINFO databases up to February 2011.
  • Extracted and analyzed data using odds ratios (Peto OR) with 95% confidence intervals (CI).

Main Results:

  • Open-entry techniques significantly reduced failed entry compared to Veress Needle (Peto OR 0.12).
  • Direct-trocar entry showed advantages over Veress Needle, including lower failed entry rates (Peto OR 0.21), less extraperitoneal insufflation (Peto OR 0.18), and reduced omental injury (Peto OR 0.28).
  • Radially expanding access system (STEP) trocar entry reduced trocar site bleeding (Peto OR 0.31) versus standard trocar entry.

Conclusions:

  • Open-entry techniques are associated with significantly less failed entry without increasing visceral or vascular injury.
  • Direct-trocar entry is a safer closed-entry technique compared to the Veress Needle, reducing failed entry, extraperitoneal insufflation, and omental injury.
  • Study limitations include small participant numbers and exclusion of high-risk patients, necessitating cautious interpretation of results for major vascular and visceral injury.