Técnica segura para a realizacao do pneumoperitônio e passagem do trocáter da regiao umbilical na cirurgia laparoscópica / Safe technique to performe the pneumoperitoneum and the trocar insertion for laparoscopic surgery

A new technique to perform the pneumoperitoneum and trocar insertion for laparoscopic surgery is presented. After a small incision of the intraumbilical skin, the aponeurosis is exposed and adequate traction is obtained by insertion of two sutures. A small incision is made in the aponeurosis to overcome its resistence to the insertion of the Veress needle and the first trocar. Thirty-two laparoscopic procedure were performed using the conventional technique and the results were compared to 404 cases using the above described modification. No intestinal or vascular injury was observed in any of the groups. The incidence of umbilical infection and postoperative hernia were significantly lower in the modified technique group. We conclude that the described modification is safer and helps the surgeon to avoid complications in laparoscopic surgery