Author/Authors :
Shayani-Nasab، Hamid نويسنده Urology & Nephrology Research Center, Department of Urology, Hamadan University of Medical Sciences, Hamadan , , Amir-Zargar، Mohammad Ali نويسنده Urology & Nephrology Research Center, Department of Urology, Hamadan University of Medical Sciences, Hamadan, , , Mousavi-Bahar، Seyed Habibollah نويسنده Urology & Nephrology Research Center, Department of Urology, Hamadan University of Medical Sciences, Hamadan , , Iloon Kashkouli، Abdolmajid نويسنده Urology & Nephrology Research Center, Department of Urology, Hamadan University of Medical Sciences, Hamadan , , Ghorban-Poor، Manoochehr نويسنده Department of General Surgery, Hamadan University of Medical Sciences, Hamadan , , Marzieh Farimani، Marzieh نويسنده Endometr & Endometriosis Research Center, Department of Gynecology, Hamadan University of Medical Sciences, Hamadan , , Saadat Torabian، Saadat نويسنده Department of Community Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, , , Amir Ali Tavab، Amir Ali نويسنده Islamic Azad University, Tehran Medical Branch, Tehran, ,
Abstract :
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 techniques
were evaluated prospectively in 453 consecutive patients who had undergone laparoscopy
either 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 the
VN, and 180 (39.7%) with the modified OA technique. Statistical differences were seen
among the groups in terms of mean age (P = .003), male-to-female ratio (P < .001), indications
for the operation (P < .001), and mean trocar insertion time (P < .001). Three major
complications (1 colon perforation and 2 iliac artery injuries) occurred in DT and one (iliac
artery 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 with
major complications. Therefore, modified OA seems to be safe, feasible, and most acceptable
due to less major complications.
