A Golan1, R Sagiv, A Debby, M Glezerman. 1. Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon 58100, Israel.
Abstract
STUDY OBJECTIVE: To access a method that attempts to reduce the risk of bowel and blood vessel trauma in entry-risk patients during laparoscopy. DESIGN: Three-year observational study (Canadian Task Force classification II-2). SETTING: Tertiary university hospital. PATIENTS: Thirty-one women defined as entry-risk due to previous multiple abdominal surgeries or repair of umbilical hernia. INTERVENTION: Laparoscopy performed with a 2 mm minilaparoscope inserted at Palmer's point, a midclavicular position under the lower left rib. MEASUREMENTS AND MAIN RESULTS: In most cases the minilaparoscope was used to inspect the anterior abdominal wall for adhesions. When a location free from adhesions was seen or created by adhesiolysis, the 5- or 10-mm cannula was inserted, followed by the laparoscope. Periumbilical adhesions were more common after previous longitudinal incisions. There were no complications. CONCLUSIONS: Minilaparoscopy is safe and effective for identifying and preparing a proper cannula insertion point. This may be useful for avoiding bowel or other cannula-related trauma in women at high risk for such a complication.
STUDY OBJECTIVE: To access a method that attempts to reduce the risk of bowel and blood vessel trauma in entry-risk patients during laparoscopy. DESIGN: Three-year observational study (Canadian Task Force classification II-2). SETTING: Tertiary university hospital. PATIENTS: Thirty-one women defined as entry-risk due to previous multiple abdominal surgeries or repair of umbilical hernia. INTERVENTION: Laparoscopy performed with a 2 mm minilaparoscope inserted at Palmer's point, a midclavicular position under the lower left rib. MEASUREMENTS AND MAIN RESULTS: In most cases the minilaparoscope was used to inspect the anterior abdominal wall for adhesions. When a location free from adhesions was seen or created by adhesiolysis, the 5- or 10-mm cannula was inserted, followed by the laparoscope. Periumbilical adhesions were more common after previous longitudinal incisions. There were no complications. CONCLUSIONS: Minilaparoscopy is safe and effective for identifying and preparing a proper cannula insertion point. This may be useful for avoiding bowel or other cannula-related trauma in women at high risk for such a complication.