Modified Open Laparoscopy Using a 5-mm Laparoscope.

Area of Science:

• Minimally Invasive Surgery
• Surgical Techniques
• Laparoscopy

Background:

• Conventional 10-mm open laparoscopy for minimized injury risks has drawbacks including larger incisions and fascial sutures.
• Existing 5-mm laparoscopy optics are advanced, yet open techniques using them are underexplored.

Purpose of the Study:

• To present a modified 5-mm open laparoscopy technique.
• To address limitations of current open and closed 10-mm laparoscopic entry methods.

Main Methods:

• A modified open technique using 5-mm instruments without fascial sutures.
• Fascia elevation and incision, followed by blunt peritoneal perforation with a hemostat.
• Insertion of a blunt trocar and sleeve, followed by 5-mm laparoscope placement before insufflation.

Main Results:

• Approximately 350 procedures performed with only one major complication (perforated transverse colon).
• Minor carbon dioxide leakage was infrequent.
• No instances of wound infection or hernia were reported.

Conclusions:

• The modified 5-mm open technique mitigates disadvantages of conventional 10-mm laparoscopic entries.
• This approach avoids blind insertion of sharp instruments, enhancing patient safety.