Rohan M Gett1, Mark G Joseph. 1. Department of Surgery, University of Sydney, Concord Repatriation General Hospital, New South Wales, Australia. rohangett@hotmail.com
Abstract
BACKGROUND: Most techniques of Hasson cannula insertion still involve a significant risk of visceral or vascular damage. This is true even for the modified open techniques of cannulation. METHODS: A technique of sequential clipping and elevation of abdominal wall layers is described, which permits safer Hasson cannulation at the umbilicus or at other sites on the abdomen even in the presence of underlying adhesions. RESULTS: Eight hundred and seventy-six patients underwent laparoscopic cholecystectomy using this technique of Hasson cannulation. Forty-two of these patients had the cannula placed at other sites other than the umbilicus because of previous surgery and suspected adhesions. Using this technique there were no major complications. Specifically, this technique did not incur any cases of visceral or vascular damage. CONCLUSIONS: The technique of sequential clipping and elevation of all layers of the abdominal wall during the insertion of the Hasson cannula allows for safer entry into the peritoneal cavity.
BACKGROUND: Most techniques of Hasson cannula insertion still involve a significant risk of visceral or vascular damage. This is true even for the modified open techniques of cannulation. METHODS: A technique of sequential clipping and elevation of abdominal wall layers is described, which permits safer Hasson cannulation at the umbilicus or at other sites on the abdomen even in the presence of underlying adhesions. RESULTS: Eight hundred and seventy-six patients underwent laparoscopic cholecystectomy using this technique of Hasson cannulation. Forty-two of these patients had the cannula placed at other sites other than the umbilicus because of previous surgery and suspected adhesions. Using this technique there were no major complications. Specifically, this technique did not incur any cases of visceral or vascular damage. CONCLUSIONS: The technique of sequential clipping and elevation of all layers of the abdominal wall during the insertion of the Hasson cannula allows for safer entry into the peritoneal cavity.