The Cosmetic Benefit of Three‐Port Laparoscopic Cholecystectomy and Umbilical Trocar Insertion

1994 ◽  
Vol 6 (1) ◽  
pp. 49-51 ◽  
Author(s):  
Haruhiro INOUE ◽  
Kin‐ichi ITOH ◽  
Hikaru HORI ◽  
Yukihiko MURAOKA ◽  
Narihide GOSEJSI ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Trocar Insertion

scholarly journals Comparison of Complications between Direct Trocar Insertion Versus Veress Needle for Creation of Pneumoperitoneum in Patients Undergoing laparoscopic Cholecystectomy: A Randomized Control Trial

2021 ◽  
pp. 294-299
Author(s):  
Kamran Hamid ◽  
Shabbir Ahmad ◽  
Bahzad Akram Khan ◽  
Muhammad Faheem Answer ◽  
Amer Latif ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Needle Insertion ◽  
Veress Needle ◽  
P Value ◽  
Surgical Department ◽  
Trocar Insertion ◽  
Laparoscopic Entry ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Direct Trocar Insertion

Aim: To compare the outcomes in term of complication of Veress Needle Insertion (VNI) to Direct Trocar Insertion (DTI) for creation of pneumoperitoneum in laparoscopic cholecystectomy. Design: Randomized controlled trial Place and Duration of Study: The current analysis was conducted at Khawaja Muhammad Safdar Medical College Surgical Department, Allama Iqbal Memorial Hospital and Govt. Sardar Begum Teaching Hospital, Sialkot from September 27, 2017, to September 26, 2020. Methodology: A total of six hundred and eight (n=608) patients, having age 30 to 75 years planned for laparoscopic cholecystectomy were included in this study. Patients were randomly divided into two groups, Group A (Direct Trocar Insertion), Group B (Veress Needle Insertion). Both groups had age and sex matched males and female. All trocars and veress needle used were disposable, with a safety shield. The primary outcome of our study was to compare the complications to assess the safety levels, while total time taken by the procedure and mean time for laparoscopic entry were the secondary end points. The collected data was analyzed by using software SPSS version 22. Chi-square test was used to check the significance of variance. P-value less than 0.05 remained the statistically significant. Results: The complication rate in VNI group were significantly greater than the DTI group (p < 0.01), the duration of surgery between the two groups was not significantly different (p > 0.05), but we found statistically significant difference in mean laparoscope insertion time (DTI 3.4+ 1.4 versus VNI 4.8+ 0.7 minutes, p < 0.001). Conclusion: From the results of our study, it can be concluded that the direct trocar insertion is a safe alternative to veress needle insertion in laparoscopic cholecystectomy as it is associated with fewer complications.

Effect of different doses of remifentanil on stress response during laparoscopic cholecystectomy

2019 ◽  
Vol 15 (1) ◽  
pp. 43-49 ◽  
Author(s):  
Laura Levantesi, MD ◽  
Flaminio Sessa, MD ◽  
Elisabetta Congedo, MD ◽  
Francesco Di Nardo, MD ◽  
Marco Oggiano, MD ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Stress Response ◽  
Venous Blood ◽  
Stress Hormones ◽  
Insertion Time ◽  
Perioperative Analgesia ◽  
Trocar Insertion ◽  
Control Pain ◽  
Double Blinded ◽  
Different Doses

Objectives: An adequate perioperative analgesia reduces neuroendocrine stress response and postoperative complications. Opioids are the most effective parenteral drugs to control pain and stress response.Design: This is a prospective randomized double-blinded controlled study.Setting: Institutional tertiary level.Patients, participants: Fifty patients underwent general anesthesia with desflurane for laparoscopic cholecystectomy.Main outcome measures: To compare two different doses of remifentanil (0.15 mcg/kg/min or 0.3 mcg/kg/min) in reducing markers of stress. Perioperative stress was assessed through the dosage of adrenocorticotropic hormone (ACTH), cortisol, growth hormone (GH), and prolactin (PRL). Three venous blood samples were collected from patients: before transferring the patient to the operating room (Time 0), at the trocar insertion (Time 1), and 1 hour after the end of the surgery (Time 2).Results: Hemodynamic parameters showed no differences between the two groups. The authors observed an increase of GH and PRL in both groups at trocar insertion (Time 1) (p = 0.473 and 0.754, respectively). ACTH and cortisol showed a decrease at Time 1 and an increase after surgery (p = 0.586). The modification of stress parameters levels showed no significant differences between the two groups.Conclusions: The results of our study showed that a lower dose of remifentanil is equally effective in controlling stress hormones during laparoscopic cholecystectomy.

Direct Trocar Insertion without Pneumoperitoneum and the Veress Needle in Laparoscopic Cholecystectomy: a Comparative Study

2006 ◽  
Vol 106 (5) ◽  
pp. 541-544 ◽  
Author(s):  
E. Prieto-Díaz-Chávez ◽  
J.-L. Medina-Chávez ◽  
A. González-Ojeda ◽  
R. Anaya-Prado ◽  
B. Trujillo-Hernández ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Comparative Study ◽  
Veress Needle ◽  
Trocar Insertion ◽  
Direct Trocar Insertion

scholarly journals Comparison of the Number of Attempts in Creating Pneumoperitoneum for Laparoscopic Cholecystectomy Using Direct Trocar Versus Veress Needle Insertion

2021 ◽  
Vol 15 (7) ◽  
pp. 1787-1790
Author(s):  
Kamran Hamid ◽  
Shabbir Ahmad ◽  
Faisal Shabbir ◽  
Amer Latif ◽  
Shahzad A. ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Laparoscopic Cholecystectomy ◽  
Body Mass ◽  
Controlled Trial ◽  
Needle Insertion ◽  
Veress Needle ◽  
Key Words Laparoscopic Cholecystectomy ◽  
Safe Alternative ◽  
Trocar Insertion ◽  
Direct Trocar Insertion

Aim: To compare the number of attempts at creating pneumoperitoneum for laparoscopic cholecystectomy using direct trocar versus veress needle insertion techniques. Design: Randomized controlled trial Place and Duration of Study: Department of Surgery, Allama Iqbal Memorial Hospital Sialkot and Govt. Sardar Begum Teaching Hospital, Sialkot from 27th September 2017 to 26th September 2020. Methodology: Six hundred and eight patients of both male and female patients, having uncomplicated cholelithiasis were selected. All participants were randomized into two equal groups, Group A (direct trocarInsertion) and the Group B (veress needle insertion). All trocars and veress needle used were disposable, with a safety shield. All procedures were carried out by the single experienced surgeons and his team. Data was noted, regarding age, sex, body mass index (BMI) and the number of attempts to create the successful pneumoperitoneum. Results: The number of attempts to create successful pneumoperitoneum in DTI group was significantly feweras compared to VNI group (p=0.026) but we found no statisticallysignificant difference between age, gender, and body mass index. Conclusion: The direct trocar insertion is a safe alternative to veress needle insertion in laparoscopic cholecystectomy because it requires fewernumber of attempts for successful creation of pneumoperitoneum as compared to the veress needle. Key words: Laparoscopic cholecystectomy, Veress needle insertion, Direct trocar insertion, Pneumoperitoneum

scholarly journals COMPARATIVE EVALUATION OF TRANSUMBILICAL AND INFRAUMBILICAL 5 MM BLIND TROCAR INSERTION FOR CAMERA PORT IN LAPAROSCOPIC CHOLECYSTECTOMY

2019 ◽  
Vol 6 (18) ◽  
pp. 1383-1387
Author(s):  
Amish Wani ◽  
Ashwani Kumar Dalal ◽  
Usha Rani Dalal ◽  
Hari Rathi ◽  
Komal Komal ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Comparative Evaluation ◽  
Trocar Insertion ◽  
Camera Port

Direct trocar insertion versus veress needle insertion in laparoscopic cholecystectomy

1999 ◽  
Vol 177 (3) ◽  
pp. 247-249 ◽  
Author(s):  
Mehmet Ali Yerdel ◽  
Kaan Karayalcin ◽  
Ayhan Koyuncu ◽  
Baris Akin ◽  
Cuneyt Koksoy ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Needle Insertion ◽  
Veress Needle ◽  
Trocar Insertion ◽  
Direct Trocar Insertion

Direct Trocar Insertion: an Efficient Access Technique for Laparoscopic Cholecystectomy

2021 ◽  
Vol 15 (11) ◽  
pp. 3026-3027
Author(s):  
Imamuddin Baloch ◽  
Azhar Ali Shah ◽  
Bushra Shaikh ◽  
Saima Athar ◽  
Abdul Sami Mirani ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Subcutaneous Fat ◽  
Port Site ◽  
Access Time ◽  
Visceral Injury ◽  
Trocar Insertion ◽  
Co2 Insufflation ◽  
Port Access ◽  
Port Site Hernia ◽  
Direct Trocar Insertion

Aim: To evaluate the feasibility and safety of direct trocar insertion for gaining access to peritoneal cavity in laparoscopic cholecystectomy. Methods: An Observational study was conducted at Surgical unit II Ghulam Mohammad Mahar Medical College Hospital Sukkur from January 2016 to December 2020. Two thousand one hundred twenty (n=2120) patients were included in the study. All the patients who underwent laparoscopic cholecystectomy were included in the study. Informed and written consent was obtained from every patient to participate as study subject. Data was analyzed on SPSS version 16. Mean +/- standard deviation was calculated for age, first port access time and time to establish pneumoperitoneum. Results: Under general anesthesia with patient in supine posture, abdominal access gained by first making small incision of 10mm in skin and subcutaneous fat at sub umbilical region with No. 11 scalpel and then by direct trocar insertion followed by creation of pneumoperitoneum. Cholecystectomy performed. Study variables included first port access time, no. of attempts for DTI, extraperitoneal CO2 insufflation, port site bleeding, visceral injury, port site infection and port site hernia and were recorded on predesigned proforma. Variables like extraperitoneal CO2 insufflation, port site bleeding and visceral injury were expressed as percentage. Conclusion: We conclude that direct trocar insertion is the safe, quick and effective method for creation of pneumoperitoneum and should be employed routinely in all laparoscopic procedures. Keywords: Laparoscpy, Cholecystectomy, Trocars

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