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Entry complications in laparoscopic surgery.

Krishnakumar S, Tambe P - J Gynecol Endosc Surg (2009)

Bottom Line: To review the complications associated with laparoscopic surgery and provide clinical direction regarding the best practice based on the best available evidence.It is an evidence based fact that minimal access surgery is superior to conventional open surgery since this is beneficial to the women, community and the healthcare system.Over the past 50 years, many techniques, technologies and guidelines have been introduced to eliminate the risks associated with laparoscopic entry.Proper evaluation of the women, supported by surgical skills and good knowledge of the technology and instrumentation is the keystone to safe access and prevention of complications during laparoscopic surgery.

View Article: PubMed Central - PubMed

Affiliation: Nirmiti Fertility and IVF Centre, Thane, India.

ABSTRACT
To review the complications associated with laparoscopic surgery and provide clinical direction regarding the best practice based on the best available evidence. The laparoscopic entry techniques and technologies reviewed include the classic pneumoperitoneum (Veress/trocar), the open (Hasson), the direct trocar insertion, the use of disposable shielded trocars, radially expanding trocars and visual entry systems. Medline, Pubmed and Cochrane Databases were searched for English language articles published before December 2008. It is an evidence based fact that minimal access surgery is superior to conventional open surgery since this is beneficial to the women, community and the healthcare system.Over the past 50 years, many techniques, technologies and guidelines have been introduced to eliminate the risks associated with laparoscopic entry. No single technique or instrument has been proved to eliminate laparoscopic entry associated injury. Proper evaluation of the women, supported by surgical skills and good knowledge of the technology and instrumentation is the keystone to safe access and prevention of complications during laparoscopic surgery.

No MeSH data available.


Related in: MedlinePlus

Angulation of Veress’ needle in obese patients
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Figure 3: Angulation of Veress’ needle in obese patients

Mentions: Hurd et al. reported on CT scans of 38 unanaesthetised women of reproductive age that the position of the umbilicus was found, on average, 0.4 cm, 2.4 cm and 2.9 cm caudal to the aortic bifurcation in normal weight (BMI < 25 kg/m2), overweight (BMI 25-30 kg/m2) and obese (BMI >30 kg/m2) women respectively. In all cases, the umbilicus was cephalad to where the left common iliac vein crossed the midline at the sacral promontory. Therefore, the angle of Veress needle insertion should vary accordingly from 45 degrees in non-obese women to 90 degrees in very obese women [Figure 3].[26]


Entry complications in laparoscopic surgery.

Krishnakumar S, Tambe P - J Gynecol Endosc Surg (2009)

Angulation of Veress’ needle in obese patients
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3304260&req=5

Figure 3: Angulation of Veress’ needle in obese patients
Mentions: Hurd et al. reported on CT scans of 38 unanaesthetised women of reproductive age that the position of the umbilicus was found, on average, 0.4 cm, 2.4 cm and 2.9 cm caudal to the aortic bifurcation in normal weight (BMI < 25 kg/m2), overweight (BMI 25-30 kg/m2) and obese (BMI >30 kg/m2) women respectively. In all cases, the umbilicus was cephalad to where the left common iliac vein crossed the midline at the sacral promontory. Therefore, the angle of Veress needle insertion should vary accordingly from 45 degrees in non-obese women to 90 degrees in very obese women [Figure 3].[26]

Bottom Line: To review the complications associated with laparoscopic surgery and provide clinical direction regarding the best practice based on the best available evidence.It is an evidence based fact that minimal access surgery is superior to conventional open surgery since this is beneficial to the women, community and the healthcare system.Over the past 50 years, many techniques, technologies and guidelines have been introduced to eliminate the risks associated with laparoscopic entry.Proper evaluation of the women, supported by surgical skills and good knowledge of the technology and instrumentation is the keystone to safe access and prevention of complications during laparoscopic surgery.

View Article: PubMed Central - PubMed

Affiliation: Nirmiti Fertility and IVF Centre, Thane, India.

ABSTRACT
To review the complications associated with laparoscopic surgery and provide clinical direction regarding the best practice based on the best available evidence. The laparoscopic entry techniques and technologies reviewed include the classic pneumoperitoneum (Veress/trocar), the open (Hasson), the direct trocar insertion, the use of disposable shielded trocars, radially expanding trocars and visual entry systems. Medline, Pubmed and Cochrane Databases were searched for English language articles published before December 2008. It is an evidence based fact that minimal access surgery is superior to conventional open surgery since this is beneficial to the women, community and the healthcare system.Over the past 50 years, many techniques, technologies and guidelines have been introduced to eliminate the risks associated with laparoscopic entry. No single technique or instrument has been proved to eliminate laparoscopic entry associated injury. Proper evaluation of the women, supported by surgical skills and good knowledge of the technology and instrumentation is the keystone to safe access and prevention of complications during laparoscopic surgery.

No MeSH data available.


Related in: MedlinePlus