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

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.

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The comparative evaluation of intravenous with intramuscular clonidine for suppression of hemodynamic changes in laparoscopic cholecystectomy

Saudi Journal of Anaesthesia ◽

10.4103/1658-354x.114070 ◽

2013 ◽

Vol 7 (2) ◽

pp. 181 ◽

Cited By ~ 3

Author(s):

Manpreet Kaur ◽

Dootika Liddle ◽

Mary Verghese ◽

Ira Balakrishnan ◽

Meena Singh ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Comparative Evaluation ◽

Hemodynamic Changes

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

Digestive Endoscopy ◽

10.1111/j.1443-1661.1994.tb00662.x ◽

1994 ◽

Vol 6 (1) ◽

pp. 49-51 ◽

Cited By ~ 3

Author(s):

Haruhiro INOUE ◽

Kin‐ichi ITOH ◽

Hikaru HORI ◽

Yukihiko MURAOKA ◽

Narihide GOSEJSI ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Trocar Insertion

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Comparative Evaluation of Dexmedetomidine and Esmolol on Hemodynamic Responses During Laparoscopic Cholecystectomy

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2015/11607.5674 ◽

2015 ◽

Cited By ~ 1

Author(s):

Vinit K. Srivastava

Keyword(s):

Laparoscopic Cholecystectomy ◽

Comparative Evaluation ◽

Hemodynamic Responses

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Intraperitoneal bupivacaine alone or with dexmedetomidine or tramadol for post-operative analgesia following laparoscopic cholecystectomy: A comparative evaluation

Indian Journal of Anaesthesia ◽

10.4103/0019-5049.155001 ◽

2015 ◽

Vol 59 (4) ◽

pp. 234 ◽

Cited By ~ 10

Author(s):

Usha Shukla ◽

T Prabhakar ◽

Kiran Malhotra ◽

Dheeraj Srivastava ◽

Kriti Malhotra

Keyword(s):

Laparoscopic Cholecystectomy ◽

Comparative Evaluation ◽

Intraperitoneal Bupivacaine

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

Journal of Opioid Management ◽

10.5055/jom.2019.0485 ◽

2019 ◽

Vol 15 (1) ◽

pp. 43-49 ◽

Cited By ~ 1

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.

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