The role of optical access trocars in laparoscopic surgery.

A literature review between 2000 and 2005 has been conducted for laparoscopic access techniques. The blind insertion of a Veress needle or first trocar to create the pneumoperitoneum has been shown to cause vascular and visceral injuries. To reduce the risk of peritoneal entry, many surgeons prefer an open-access technique, like a Hasson trocar. Other trocars that can be used for laparoscopic entry are direct trocars and radially expanding trocars. No specific technique has been shown to be superior in preventing vascular and visceral complications. Optical trocars combine the advantages of the different entry techniques. This chapter describes the different entry techniques, indications, and clinical experiences of the optical trocars. An optical trocar provides a safe and feasible primary insertion method for laparoscopy in patients prone to access injuries.