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Related Concept Videos

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

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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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Related Experiment Video

Updated: Sep 1, 2025

Techniques of Laparoscopic Right Posterior Sectionectomy: Glissonian Approach and a Parenchymal Transection Technique
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Laparoscopic entry techniques: Which should you prefer?

Diego Raimondo1, Antonio Raffone1,2, Antonio Travaglino3

  • 1Division of Gynecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics
|August 18, 2022
PubMed
Summary

The direct trocar method is safer for laparoscopic entry than Veress needle or open techniques, reducing complications. This evidence update aids in selecting the safest laparoscopic entry approach.

Keywords:
accesscomplicationsguidelineslaparoscopyminimally invasiverecommendationsafetysurgery

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Techniques
  • Patient Safety

Background:

  • The safest method for laparoscopic entry remains debated after two decades.
  • Lack of consensus impacts clinical practice and patient outcomes.
  • Need for updated evidence on laparoscopic entry techniques.

Purpose of the Study:

  • To synthesize current evidence on the safety of various laparoscopic entry techniques.
  • To compare complication rates and identify the safest method.
  • To inform clinical decision-making regarding laparoscopic access.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs).
  • Searched six electronic databases from inception to February 2021.
  • Compared entry-related complications and time using pooled odds ratios and mean differences.

Main Results:

  • Direct trocar associated with lower visceral injury and trocar site infection compared to open.
  • Veress needle showed higher risk of omental injury, failed entry, and extraperitoneal insufflation versus direct trocar.
  • Veress needle also had higher risks for omental injury, failed entry, extraperitoneal insufflation, and incisional hernia compared to open method.

Conclusions:

  • The direct trocar technique appears to be associated with a lower risk profile.
  • Direct trocar may be preferable to Veress needle and open methods for laparoscopic entry.
  • Evidence suggests direct trocar enhances patient safety during laparoscopic procedures.