Guideline No. 412: Laparoscopic Entry for Gynaecological Surgery

Area of Science:

• Minimally Invasive Gynecological Surgery
• Surgical Technology Assessment

Background:

• Laparoscopic surgery is widely used in gynecology.
• Selection of appropriate entry techniques and technologies is crucial for patient safety and surgical outcomes.
• Existing guidelines may not comprehensively cover all modern entry methods.

Purpose of the Study:

• To evaluate the benefits and risks of various laparoscopic surgery entry techniques and technologies.
• To provide clinical direction for selecting optimal methods in gynecological surgery.
• To address complications associated with different laparoscopic access methods.

Main Methods:

• Systematic literature search of English-language articles (September 2005 - December 2019) in major databases (PubMed/MEDLINE, Embase, Scopus, Cochrane).
• Keywords included "laparoscopic entry," "pneumoperitoneum," "Veress needle," "Hasson technique," "trocar" types, and "laparoscopic complications."
• Evidence quality and recommendation strength assessed using the Canadian Task Force on Preventive Health Care criteria.

Main Results:

• The review encompassed closed (Veress needle), direct trocar insertion, open (Hasson) techniques, visual entry systems, and various disposable trocars.
• Analysis focused on benefits, risks, and associated complications for each method.
• Specific recommendations were formulated based on the synthesized evidence.

Conclusions:

• Implementation of this guideline is expected to enhance decision-making processes for laparoscopic surgery entry.
• Optimized selection of entry techniques can improve safety and efficacy in gynecological laparoscopic procedures.
• The guideline serves as a valuable resource for surgeons performing laparoscopic gynecological surgery.