Avoiding entry complications
Epublication WebSurg.com, Jan 2015;15(01). URL: http://websurg.com/doi/lt03enfaria001
More then 50% of major laparoscopic complications occur during the initial entry into the abdominal wall. In this lecture, the most frequent entry techniques are reviewed (Veress needle, open and direct entry techniques) and compared in terms of entry risks. New devices for the entry process have recently emerged. Nevertheless, the risk of entry complications has remained the same since the last 25 years. The entry mode is also discussed in particular cases such as previous midline laparotomy, morbid obesity, and slimness. Above all, we should use the entry technique which makes us feel more comfortable since there is no evidence that any single technique or specialized instruments to enter the abdomen helps to reduce the occurrence of vascular and organ injuries.