Giuseppe Ciravolo1, Paolo Donarini2, Fabio Rampinelli1, Chiara Visenzi3, Franco Odicino4. 1. Department of Obstetrics and Gynecology, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia, Italy (Drs. Ciravolo, Donarini, and Rampinelli). 2. Department of Obstetrics and Gynecology, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia, Italy (Drs. Ciravolo, Donarini, and Rampinelli). Electronic address: paolo.donarini@gmail.com. 3. Department of Obstetrics and Gynecology, Fondazione Poliambulanza, Brescia, Italy (Dr. Visenzi). 4. Department of Obstetrics and Gynecology, University of Brescia, Brescia, Italy (Mr. Odicino).
Abstract
STUDY OBJECTIVE: To analyze the complications experienced and describe laparoscopic surgery using a gasless optical trocar. DESIGN: A retrospective study. SETTING: A department of obstetrics and gynecology in a tertiary center in Italy. PATIENTS: Seven thousand four hundred thirty-one surgical procedures were performed. INTERVENTIONS: From the hospital database, data were evaluated regarding major complications of laparoscopy with the ENDOPATH XCEL Bladeless Trocar (Ethicon, Johnson & Johnson, Somerville, NJ) performed between 2000 and 2017 by different laparoscopic surgeons. MEASUREMENTS AND MAIN RESULTS: The mean age of the patients was 40.66 ± 12.06 years (range, 13-91 years). The mean body mass index was 22.12 ± 3.64 kg/m2 (range, 15.74-41.51 kg/m2). The overall complication rate was 0.31% (23/7431 cases). Major complications included stomach perforation in 1 procedure (0.014%), ileal perforation in 2 procedures (0.028%), and blood vessel perforation in 1 procedure (0.014%). Twelve procedures were completed with initial access through the omentum and 2 through an ovarian cyst. In 5 procedures (0.067%), conversion to laparotomy was required because the optical trocar failed to reach the abdominal cavity. With regard to complications requiring further intervention (n = 9), the rate of complications was 0.12%. CONCLUSIONS: The optical gasless trocar is a feasible laparoscopic entry technique. The complication rate is lower than those reported previously.
STUDY OBJECTIVE: To analyze the complications experienced and describe laparoscopic surgery using a gasless optical trocar. DESIGN: A retrospective study. SETTING: A department of obstetrics and gynecology in a tertiary center in Italy. PATIENTS: Seven thousand four hundred thirty-one surgical procedures were performed. INTERVENTIONS: From the hospital database, data were evaluated regarding major complications of laparoscopy with the ENDOPATH XCEL Bladeless Trocar (Ethicon, Johnson & Johnson, Somerville, NJ) performed between 2000 and 2017 by different laparoscopic surgeons. MEASUREMENTS AND MAIN RESULTS: The mean age of the patients was 40.66 ± 12.06 years (range, 13-91 years). The mean body mass index was 22.12 ± 3.64 kg/m2 (range, 15.74-41.51 kg/m2). The overall complication rate was 0.31% (23/7431 cases). Major complications included stomach perforation in 1 procedure (0.014%), ileal perforation in 2 procedures (0.028%), and blood vessel perforation in 1 procedure (0.014%). Twelve procedures were completed with initial access through the omentum and 2 through an ovarian cyst. In 5 procedures (0.067%), conversion to laparotomy was required because the optical trocar failed to reach the abdominal cavity. With regard to complications requiring further intervention (n = 9), the rate of complications was 0.12%. CONCLUSIONS: The optical gasless trocar is a feasible laparoscopic entry technique. The complication rate is lower than those reported previously.