Related Experiment Video
Updated: Jul 14, 2026
Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy
Published on: June 25, 2013
Abdominal access in laparoscopic surgery of obese patients: a novel abdominal access technique
Mesut Polat1, Adnan Incebiyik2, Omer Tammo3
1From the Department of Obstetrics and Gynecology, Zeynep Kamil Training and Research Hospital, Istanbul, Turkey.
Background:
An important step in laparoscopic surgery is abdominal access. Several abdominal access techniques have been described to reduce complications. We compare our novel abdominal access technique (MESAD) with other abdominal access techniques, particularly to reduce complications in obese patients.
Objective:
Compare the MESAD method and other methods we use for abdominal access in gynecologic laparoscopic surgery of obese patients DESIGN: Retrospective SETTING: Gynecology department in university hospital PATIENTS AND METHODS: Patients who underwent abdominal access by the MESAD technique, the Veress needle technique, and the Hasson technique were included in our study. In addition to demographic data, minor and major complications, number of unsuccessful attempts, conversion to another technique, and abdominal access times were collected from all patient files.
Main Outcome Measures:
Clinical data and complications SAMPLE SIZE: 66 patients, 26 by MESAD technique, 24 by the Veress needle technique, and 16 by the Hasson technique.
Results:
There were two major complications (one in the Veress group and one in the Hasson technique group) and 7 minor complications. No significant difference was found between the groups in terms of complications (P=.477, P=.476, respectively). The fastest technique for abdominal access was in the MESAD technique whereas the slowest was in the Hasson (P<.001). The failure of abdominal access and subsequent conversion to another technique was most common in the Veress group. However, no significant difference was found between the groups (P=.092).
Conclusions:
The MESAD technique is an easy method to both learn and teach. We think that the low major-minor complication rates in the MESAD technique will allow surgeons to reduce their anxiety at the first entry and to perform a more comfortable operation.
Limitations:
Retrospective CONFLICT OF INTEREST: None.
Insights
The novel MESAD technique for abdominal access in laparoscopic surgery is as safe as Veress and Hasson methods, with faster insertion times. This technique is easy to learn and teach, potentially reducing surgeon anxiety during gynecologic procedures in obese patients.
Area of Science:
- Minimally Invasive Surgery
- Surgical Access Techniques
- Gynecologic Laparoscopy
Background:
- Abdominal access is a critical step in laparoscopic surgery.
- Various techniques exist to minimize complications during surgical entry.
- Obese patients present unique challenges for safe abdominal access.
Purpose of the Study:
- To compare the safety and efficiency of the novel Minimally Invasive Surgical Access Device (MESAD) technique against traditional Veress needle and Hasson techniques.
- To evaluate complication rates and insertion times for abdominal access in obese patients undergoing gynecologic laparoscopic surgery.
Main Methods:
- Retrospective study of 66 patients undergoing gynecologic laparoscopic surgery.
- Patients were grouped by abdominal access technique: MESAD (n=26), Veress needle (n=24), and Hasson (n=16).
- Data collected included demographics, complication types (minor/major), unsuccessful attempts, conversions, and access times.
Main Results:
- No significant difference in major or minor complication rates was observed between MESAD, Veress, and Hasson techniques (P=.477, P=.476).
- The MESAD technique demonstrated significantly faster abdominal access times compared to the Hasson technique (P<.001).
- While Veress needle had the highest rate of access failure and conversion, this difference was not statistically significant between groups (P=.092).
Conclusions:
- The MESAD technique is a safe and efficient method for abdominal access in gynecologic laparoscopic surgery, particularly in obese patients.
- Its ease of learning and teaching, coupled with low complication rates, may enhance surgeon confidence and procedural comfort.
- MESAD offers a promising alternative for surgical entry, potentially improving the patient and surgeon experience.
