Modified Open Laparoscopy Using a 5-mm Laparoscope.

Abstract:

BACKGROUND:In an effort to minimize injuries associated with closed laparoscopic entry, many surgeons use a 10-mm standard open laparoscopy technique. Disadvantages of this open technique are that it requires a larger incision, fascial sutures, and does not always achieve an airtight seal. Although 5-mm laparoscopics with excellent optics are available, little has been written about open techniques using them. TECHNIQUE:We report a modified 5-mm open laparoscopy technique without fascial sutures. The fascia is elevated with small Kocher forceps and incised in the midline. The peritoneum is bluntly perforated with a hemostat-directed cephalad, and a blunt trocar with a sleeve is inserted in this direction. After rotating the sleeve toward the pelvis, a 5-mm laparoscope is placed into the abdomen before insufflation. EXPERIENCE:We have performed approximately 350 laparoscopies with only one major complication of a perforated transverse colon densely adherent beneath the umbilicus in a woman without previous abdominal surgery. Minor carbon dioxide leakage was uncommon and no wound infections or hernias occurred. CONCLUSION:This 5-mm modified open laparoscopic entry technique minimizes some of the disadvantages associated with conventional open and closed 10-mm laparoscopic techniques while avoiding blind placement of sharp instruments into the peritoneal cavity.

journal_name

Obstet Gynecol

authors

Pryor KP,Hurd WW

doi

10.1097/AOG.0000000000001202

subject

Has Abstract

pub_date

2016-03-01 00:00:00

pages

535-538

issue

3

eissn

0029-7844

issn

1873-233X

pii

00006250-201603000-00016

journal_volume

127

pub_type

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