scholarly journals Is Pneumoperitoneum Really Required before Primary Trocar Insertion in Laparoscopy?

2009 ◽  
Vol 1 (2) ◽  
pp. 29-31
Author(s):  
Krishan Kapur
Keyword(s):  
Peritoneal Cavity ◽  
Veress Needle ◽  
Government Hospital ◽  
Mesenteric Injury ◽  
Trocar Insertion ◽  
Laparoscopic Procedures ◽  
Direct Trocar Insertion ◽  
Primary Trocar

ABSTRACT Objectives Traditionally a Veress needle is used to create a pneumoperitoneum before entering the primary trocar/cannula for laparoscopy. Insufflation of gas into the peritoneal cavity with the Veress needle is not without its problems. To do away with these problems the technique of direct trocar access was started. Materials and methods Between 01 Jan 2003 and 31 Dec 2008— 2958 laparoscopic procedures were carried out in a Government hospital. 345 patients out of these had undergone previous laparotomies. In all cases direct trocar insertion without pneumoperitoneum was done. Result In this series there were no complications except in one case there was mesenteric injury with bleeding which required a laparotomy. There were no failed laparoscopies. Conclusion We have found that direct trocar insertion before creating pneumoperitoneum is a safe and effective method for laparoscopic access and offers advantages over the conventional access modality of using a Veress needle for pneumoperitoneum.

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.

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

Direct trocar insertion without previous pneumoperitoneum versus insertion after insufflation with Veress needle in laparoscopic gynecological surgery: a prospective cohort study

2019 ◽  
Vol 39 (7) ◽  
pp. 1000-1005
Author(s):  
Manuel Pantoja Garrido ◽  
Zoraida Frías Sánchez ◽  
Ignacio Zapardiel Gutiérrez ◽  
Rafael Torrejón ◽  
Cecilia Jiménez Sánchez ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Veress Needle ◽  
Gynecological Surgery ◽  
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

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