BACKGROUND: The background of this investigation is based on a common surgical problem: The access in laparoscopic surgery is more difficult in women with previous abdominopelvic surgery, since adhesions and viscera could be close to the point of trocar insertion. PURPOSE: The authors analyzed the safety and the efficacy of a modified direct optical entry (DOE) method versus the Hasson's method by open laparoscopy (OL) in women with previous abdominopelvic surgery in a preliminary prospective case-control study. MATERIALS AND METHODS: A total of 168 women underwent laparoscopic surgery in university-affiliated hospitals: 86 were assigned to abdominal DOE (group A) and 82 to OL (group B). The main outcome measures were statistically compared: time required for entry into abdomen, blood loss, and occurrence of vascular and/or bowel injury. All patients had an intraperitoneal view of the primary port site during surgical procedure. RESULTS: Statistical differences, in favor of the DOE group (P < .01), were found in duration of entry and blood loss. The vascular and bowel injuries in OL versus DOE were not statistically different. CONCLUSIONS: Obtaining access to the peritoneal cavity in laparoscopic surgery is more difficult in patients with previous abdominopelvic surgery, since it can become a difficult, time-consuming, and occasionally hazardous procedure. The study results suggest that DOE is advantageous when compared with OL in terms of saving time enabling a safe and expeditious visually guided entry for laparoscopy.
RCT Entities:
BACKGROUND: The background of this investigation is based on a common surgical problem: The access in laparoscopic surgery is more difficult in women with previous abdominopelvic surgery, since adhesions and viscera could be close to the point of trocar insertion. PURPOSE: The authors analyzed the safety and the efficacy of a modified direct optical entry (DOE) method versus the Hasson's method by open laparoscopy (OL) in women with previous abdominopelvic surgery in a preliminary prospective case-control study. MATERIALS AND METHODS: A total of 168 women underwent laparoscopic surgery in university-affiliated hospitals: 86 were assigned to abdominal DOE (group A) and 82 to OL (group B). The main outcome measures were statistically compared: time required for entry into abdomen, blood loss, and occurrence of vascular and/or bowel injury. All patients had an intraperitoneal view of the primary port site during surgical procedure. RESULTS: Statistical differences, in favor of the DOE group (P < .01), were found in duration of entry and blood loss. The vascular and bowel injuries in OL versus DOE were not statistically different. CONCLUSIONS: Obtaining access to the peritoneal cavity in laparoscopic surgery is more difficult in patients with previous abdominopelvic surgery, since it can become a difficult, time-consuming, and occasionally hazardous procedure. The study results suggest that DOE is advantageous when compared with OL in terms of saving time enabling a safe and expeditious visually guided entry for laparoscopy.
Authors: Andrea Tinelli; Antonio Malvasi; Ospan A Mynbaev; Daniel Alberto Tsin; Fausto Davila; Guillermo Dominguez; Emanuele Perrone; Farr R Nezhat Journal: JSLS Date: 2013 Oct-Dec Impact factor: 2.172
Authors: Andrea Tinelli; Nicola Gasbarro; Pietro Lupo; Antonio Malvasi; Daniel A Tsin; Fausto Davila; Guillermo Dominguez; Liselotte Mettler; Paul Alan Wetter Journal: JSLS Date: 2012 Apr-Jun Impact factor: 2.172
Authors: Tammy Kindel; Nicholas Latchana; Mamta Swaroop; Umer I Chaudhry; Sabrena F Noria; Rachel L Choron; Mark J Seamon; Maggie J Lin; Melissa Mao; James Cipolla; Maher El Chaar; Dane Scantling; Niels D Martin; David C Evans; Thomas J Papadimos; Stanislaw P Stawicki Journal: Int J Crit Illn Inj Sci Date: 2015 Jul-Sep