scholarly journals A comparative study between direct safety trocar insertion versus veress needle technique for creating pneumoperitoneum in laparoscopic surgeries

2021 ◽  
Vol 8 (10) ◽  
pp. 3103
Author(s):  
Ashirwad Datey ◽  
Satyendra Jain ◽  
Rahul Patel
Keyword(s):  
Needle Insertion ◽  
Veress Needle ◽  
Insertion Technique ◽  
Trocar Insertion ◽  
Needle Technique ◽  
Significant Difference ◽  
Operative Complications ◽  
Direct Trocar Insertion ◽  
Group A ◽  
Group B

Background: There are two methods of trocar insertion in laparoscopic surgeries one is direct insertion and second is Veress needle insertion. In this study we compared these two methods.Methods: In this study we divided 50 patients equally into two group group A for in group A patients, direct trocar insertion technique was used for creation of pneumoperitoneum whereas amongst patients of group B, pneumoperitoneum was created using Veress needle insertion technique.Results: The incidence of visceral injuries, vascular injuries and other post-operative complications were similar in both the groups. The present study observed no significant difference in failure rates between two methods.Conclusions: Both the techniques i.e.; Direct trocar insertion (DTI) and Veress needle technique are equally effective, safe and feasible for creation of pneumoperitoneum during laparoscopic procedure.

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.

Laparoscopic versus open partial nephrectomy for the management of highly complex renal tumors with PADUA score ⩾10: A single center analysis.

2021 ◽  
pp. 039156032110016
Author(s):  
Francesco Chiancone ◽  
Marco Fabiano ◽  
Clemente Meccariello ◽  
Maurizio Fedelini ◽  
Francesco Persico ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Operation Time ◽  
Renal Tumors ◽  
Open Partial Nephrectomy ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Post Operative Complications

Introduction: The aim of this study was to compare laparoscopic and open partial nephrectomy (PN) for renal tumors of high surgical complexity (PADUA score ⩾10). Methods: We retrospectively evaluated 93 consecutive patients who underwent PN at our department from January 2015 to September 2019. 21 patients underwent open partial nephrectomy (OPN) (Group A) and 72 underwent laparoscopic partial nephrectomy (LPN) (Group B). All OPNs were performed with a retroperitoneal approach, while all LPNs were performed with a transperitoneal approach by a single surgical team. Post-operative complications were classified according to the Clavien-Dindo system. Results: The two groups showed no difference in terms of patients’ demographics as well as tumor characteristics in all variables. Group A was found to be similar to group B in terms of operation time ( p = 0.781), conversion to radical nephrectomy ( p = 0.3485), and positive surgical margins ( p = 0.338) while estimated blood loss ( p = 0.0205), intra-operative ( p = 0.0104), and post-operative ( p = 0.0081) transfusion rates, drainage time ( p = 0.0012), pain score at post-operative day 1 (<0.0001) were significantly lower in Group B. The rate of enucleation and enucleoresection/polar resection was similar ( p = 0.1821) among the groups. Logistic regression analysis indicated that preoperative factors were not independently associated with the surgical approach. There was a statistically significant difference in complication rate (<0.0001) between the two groups even if no significant difference in terms of grade ⩾3 post-operative complications ( p = 0.3382) was detected. Discussion: LPN represents a feasible and safe approach for high complex renal tumors if performed in highly experienced laparoscopic centers. This procedure offers good intraoperative outcomes and a low rate of post-operative complications.

Carpal Ligament Decompression Under Local Anaesthesia: the Effect of lidocaine warming and Alkalinisation on Infiltration Pain

2004 ◽  
Vol 29 (1) ◽  
pp. 32-34 ◽  
Author(s):  
C. K. YIANNAKOPOULOS
Keyword(s):  
Visual Analogue Scale ◽  
Carpal Tunnel ◽  
Analogue Scale ◽  
Needle Insertion ◽  
Injection Pain ◽  
Significant Difference ◽  
Skin Infiltration ◽  
Group A ◽  
Vas Scores ◽  
Group B

This study investigated the effects of alkalinization and warming of lidocaine 1% on injection pain in patients undergoing carpal tunnel decompression. Sixty-four adult patients were randomly allocated into one of three groups: Group A ( n=20) received plain lidocaine 1%, Group B ( n = 22) alkalinized lidocaine and Group C ( n = 22) warmed and alkalinized lidocaine. Pain on needle insertion and on infiltration was assessed using a 100 mm Visual Analogue Scale (VAS). There was no significant difference regarding pain on needle insertion whereas significant differences were noted in reference to infiltration pain. In Groups B and C (alkalinized lidocaine) the VAS scores on skin infiltration were significantly lower than in Group A, while the pain score in Group C (alkalinized and warmed lidocaine) was significantly lower than in Group B.

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 Effectiveness of sedation in dacryocystorhinostomy surgery

1970 ◽  
Vol 1 (1) ◽  
pp. 25-31 ◽  
Author(s):  
S Taludhar ◽  
S Adhikari ◽  
BK Bhattarai
Keyword(s):  
Local Anesthesia ◽  
Definitive Treatment ◽  
Perioperative Outcome ◽  
Chronic Dacryocystitis ◽  
Number Of Patients ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Group A ◽  
Group B

Background: Chronic dacryocystitis is a common ophthalmic problem almost always requiring surgery as the only definitive treatment. Aim: To compare the perioperative outcome of external DCR surgery under local anesthesia with and without sedation. Subjects and methods: One hundred consecutive patients with chronic dacryocystitis undergoing dacryocystorhinostomy (DCR) surgery were randomly divided into two groups using computer generated random table. Group A underwent DCR under local anesthesia (LA) without sedation and group B under LA with sedation. The outcome parameters were intra-operative pain, surgeon's comfort, intra-operative complications and duration of surgery. Statistical analysis: SPSS version 11.5 software was used. Chi square test was used to compare the difference between the groups. Results: There were 50 patients in each group. The mean age ± SD of the patients was 34.4±12.12 years (95% CI=28.89-38.55 years). Sixty-nine percent of them were female. Significantly higher number of patients experienced pain in Group A as compared to Group B (100% vs 50%, P<0.001) Surgeon's discomfort was significantly present in group A as compared to group B (70% vs 10%), (p=0.00001). Blood loss was significantly more in group A than in group B (p=0.017). There was no significant difference in the duration of surgery. The post operative success rate in both the groups was comparable after six months of followup. Conclusion: The use of sedation with LA improves the perioperative outcome of DCR surgery in terms of patient's pain, surgeon's comfort and intra-operative complications. Key words: dacryocystitis; dacryocystorhinostomy; sedation DOI: 10.3126/nepjoph.v1i1.3670 Nep J Oph 2009;1(1):25-31

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

DeVega versus ring annuloplasty in severe functional tricuspid insufficiency and their impact on the right ventricle

2019 ◽  
Vol 1 (4) ◽  
pp. 133-139
Author(s):  
Yasser Hamdy ◽  
Mohammed Mahmoud Mostafa ◽  
Ahmed Elminshawy
Keyword(s):  
Right Ventricular ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Early Postoperative Period ◽  
Tricuspid Valve Repair ◽  
Ring Annuloplasty ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Right

Background: Functional tricuspid valve regurgitation secondary to left-sided valve disease is common. DeVega repair is simple, but residual regurgitation with subsequent impairment of the right ventricular function is a concern. This study aims to compare tricuspid valve repair using DeVega vs. ring annuloplasty and their impact on the right ventricle in the early postoperative period and after six months. Methods: This is a prospective cohort study of 51 patients with rheumatic heart disease who underwent tricuspid valve repair for secondary severe tricuspid regurgitation. Patients were divided into two groups: group A; DeVega repair (n=34) and group B; ring annuloplasty repair (n=17). Patients were assessed clinically and by echocardiography before discharge and after six months for the degree of tricuspid regurgitation, right ventricular diameter and tricuspid annular plane systolic excursion (TAPSE). Results: Preoperative echocardiographic assessment showed no difference in left ventricular end-systolic diameter, end-diastolic diameter, ejection fraction and right ventricular diameter, however; group A had significantly better preoperative right ventricular function measured by TAPSE (1.96 ± 0.27 vs1.75 ± 0.31 cm; p=0.02). Group B had significantly longer cardiopulmonary bypass time (127.65 ± 13.56 vs. 111.74 ± 18.74 minutes; p= 0.003) and ischemic time (99.06 ± 11.80 vs. 87.15 ± 16.01 minutes; p= 0.009). Pre-discharge, there was no statistically significant difference in the degree of tricuspid regurgitation, but the right ventricular diameter was significantly lower in group B (2.66 ± 0.41 and 2.40 ± 0.48 cm; p=0.049). After six months of follow up, the degree of tricuspid regurgitation (p= 0.029) and the right ventricular diameter were significantly lower in the ring annuloplasty group (2.56 ± 0.39 and 2.29 ± 0.44 cm; p=0.029). Although there was a statistically significant difference in preoperative TAPSE, this difference disappeared after six months. Conclusion: Both DeVega and ring annuloplasty techniques were effective in the early postoperative period, ring annuloplasty was associated with lesser residual regurgitation and better right ventricular remodeling in severe functional tricuspid regurgitation than DeVega procedure after 6-months of follow up.

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