Open Technique Versus Blind Technique in Placement of Primary Ports in Laparoscopic Procedures- A Prospective Cohort Study

Abstract

Introduction: Laparoscopic access has always been a challenge because it has been associated with severe complications and sometimes fatal also. Aim: To compare open technique versus blind technique in placement of primary port in various laparoscopic procedures in terms of operative time, complications, ease of use and acceptability. Materials and Methods: This prospective cohort study was conducted at Government Medical College, Patiala, Punjab, India, between June 2014 to August 2016. The study included 100 patients, which were divided into two groups. Group A (n=50) received placement of primary port by open technique and Group B (n=50) received placement of primary port by blind technique. The time taken for access into peritoneal cavity and duration of surgery was noted. Multivariate analysis done using Chi-square test, p-value of less than 0.05 was considered significant. Results: Mean age of patients in group A and group B was 42.66±12.37 years and 43.06±14.67 years, respectively. Majority of patients were females in both groups (n=45 in group A and n=39 in group B). There was no significant difference in time taken for access into peritoneal cavity (p-value>0.05). The duration of hospital stay (in hours) of the patients was 36.96 in Group A and 34.42 in Group B which was not statistically significant. The incidence of intraoperative and postoperative complications was not significant. Most common complication port site infections 3 (6%) in Group A. Conclusion: There was no significant difference between the two techniques with respect to time taken for peritoneal access and complications. In expert hands, both methods are comparable.

Keywords

• complications
• gastrointestinal tract
• pneumoperitoneum
• surgical instruments
• visual control