BACKGROUND: We aimed to compare the direct trocar insertion (DTI) and Veress needle insertion (VNI) techniques in laparoscopic bariatric surgery. MATERIALS AND METHODS:Eighty-one patients scheduled for bariatric surgery at Inonu University, Malatya, Turkey, were included in this study. In 39 patients, a bladed retractable nonoptical trocar was used for DTI, and VNI was performed in 42 patients. Intraoperative access-related parameters were compared. Data were analyzed with Student's t and chi-squared tests. A P value of <.05 was considered significant. RESULTS: Both groups had comparable demographic profiles. Laparoscopic entry time was shorter in the DTI group (79.6 ± 94.6 versus 217.6 ± 111.0 seconds; P < .0001). Successful entry rates in the first attempt, CO2 consumptions, failed attempt rates, and overall intraoperative complication rates were similar. However, in the DTI group, 2 patients had mesenteric injuries, and 1 of them required conversion to open surgery due to the mesenteric hemorrhage. CONCLUSIONS: DTI in obese patients significantly shortens the entry time, but there can be severe complications with DTI when a nonoptical bladed trocar is used blindly. Actually, neither method can be recommended for entry into the abdomen in this population based on our results. If the surgeon has to choose a nonoptical trocar in bariatric surgery, preference for the VNI technique instead of the DTI technique is safer.
RCT Entities:
BACKGROUND: We aimed to compare the direct trocar insertion (DTI) and Veress needle insertion (VNI) techniques in laparoscopic bariatric surgery. MATERIALS AND METHODS: Eighty-one patients scheduled for bariatric surgery at Inonu University, Malatya, Turkey, were included in this study. In 39 patients, a bladed retractable nonoptical trocar was used for DTI, and VNI was performed in 42 patients. Intraoperative access-related parameters were compared. Data were analyzed with Student's t and chi-squared tests. A P value of <.05 was considered significant. RESULTS: Both groups had comparable demographic profiles. Laparoscopic entry time was shorter in the DTI group (79.6 ± 94.6 versus 217.6 ± 111.0 seconds; P < .0001). Successful entry rates in the first attempt, CO2 consumptions, failed attempt rates, and overall intraoperative complication rates were similar. However, in the DTI group, 2 patients had mesenteric injuries, and 1 of them required conversion to open surgery due to the mesenteric hemorrhage. CONCLUSIONS:DTI in obesepatients significantly shortens the entry time, but there can be severe complications with DTI when a nonoptical bladed trocar is used blindly. Actually, neither method can be recommended for entry into the abdomen in this population based on our results. If the surgeon has to choose a nonoptical trocar in bariatric surgery, preference for the VNI technique instead of the DTI technique is safer.
Authors: Marcelo Loureiro; Mohamad Ramadan; El Mehdi Skalli; Pierre Blanc; Jean Michel Fabre; David Nocca Journal: Surg Endosc Date: 2017-04-07 Impact factor: 4.584
Authors: Joseph I Ikechebelu; George U Eleje; Ngozi N Joe-Ikechebelu; Chidimma Donatus Okafor; Boniface Chukwuneme Okpala; Emmanuel O Ugwu; Cyril Emeka Nwachukwu; Chukwuemeka C Okoro; Princeston C Okam Journal: Arch Gynecol Obstet Date: 2021-01-08 Impact factor: 2.344