RESUMO
Creation of pneumoperitoneum is first step in laparoscopic surgeries. Four basic techniques are used to create pneumoperitoneum i.e. blind veress needle [VN], direct trocar insertion [DTI], optical trocar insertion [OTI] and open method
Objective: The objective of the study is to determine the safety of direct trocar insertion for laparoscopic procedures
Setting: Department of Surgery, Allied/DHQ Hospital and Mujahid hospital Faisalabad
Duration of study: From 01-01-2013 to 31-12-2017 over a period of five years
Study design: Prospective randomized study
Methodology: A total of 1500 cases undergoing laparoscopic procedures were included in study.1470 [98 percent] patients had pneumoperitoneum established by DTI at umbilicus,25 patients by DTI at palmer's point and only 1 patient has pneumoperitoneum established by open method
Results: Out of 1500 cases, 1280 were females and 220 were males, male to female ratio was 1:5.8. The age of patients varied between 16-70 years mean age was calculated as 33.22+9.31 years. Pneumoperitoneum by DTI at umbilicus was achieved successfully in 1474[98.26 percent], while it was established by DTI at palmer's point in 25 [1.6 percent] patients. In only 1[0.06 percent] patient pneumoperitoneum was created by open method.1[0.06 percent] patient developed visceral injury,1[0.06 percent] patient developed port site hernia and 10[0.66 percent] patients developed port site infection
Conclusion: DTI is a safe and reliable technique for establishing pneumoperitoneum and should be used routinely