Experience with optical trocar in performing laparoscopic procedures.

We report on the results of laparoscopic procedures in 1187 patients with use of the OPTIVIEW Optical Surgical Obturator, a device that permits visually guided trocar entry without insufflation. Most of these procedures (78%) involved hiatal hernia repairs, and 51% of our patients had a history of previous abdominal procedures. Visualization and pneumoperitoneum were successfully achieved in all patients, including those who had previously undergone multiple upper-midline abdominal procedures. There were three trocar-related injuries and one late complication (0.3%), including two bowel injuries repaired at the time of initial surgery, a mesenteric injury repaired with a clip applier, and an incisional hernia that resulted from placement of the trocar at midline instead of paramedian. Results of this large series indicate that trocar-related complications associated with use of the OPTIVIEW trocar are rare.