Urology Journal (Jun 2013)

Complications of Entry Using Direct Trocar and/or Veress Needle Compared with Modified Open Approach Entry in Laparoscopy Six-Year Experience

  • Hamid Shayani-Nasab,
  • Mohammad Ali Amir-Zargar,
  • Seyed Habibollah Mousavi-Bahar,
  • Abdolmajid Iloon Kashkouli,
  • Manoochehr Ghorban-Poor,
  • Marzieh Farimani,
  • Amir Ali Tavabi

Journal volume & issue
Vol. 10, no. 2
pp. 861 – 865

Abstract

Read online

Purpose: To compare the results obtained from three routine laparoscopic entry techniques,including Direct Trocar (DT), Veress Needle (VN), and Open Approach (OA).Materials and Methods: Safety and efficacy of three main laparoscopic entry techniqueswere evaluated prospectively in 453 consecutive patients who had undergone laparoscopyeither with DT, VN, or modified OA technique in recent six years.Results: Of 453 patients, 105 (23.2%) were operated on with the DT, 168 (37.1%) with theVN, and 180 (39.7%) with the modified OA technique. Statistical differences were seenamong the groups in terms of mean age (P = .003), male-to-female ratio (P < .001), indicationsfor the operation (P < .001), and mean trocar insertion time (P < .001). Three majorcomplications (1 colon perforation and 2 iliac artery injuries) occurred in DT and one (iliacartery injury) in VN group and modified OA group had no major complication (P = .04).Four major complications required laparotomy. Minor complications were seen in 6 (5.8%),9 (5.4%), and 17 (9.4%) patients (P = .274) and gas leakage in 4 (3.8%), 16 (9.5%), and 27(15%) patients (P = .01) in DT, VN, and modified OA groups, respectively.Conclusion: Although DT and VN are rapid and relatively safe, they can be associated withmajor complications. Therefore, modified OA seems to be safe, feasible, and most acceptabledue to less major complications.

Keywords