Study on safety of first puncture in laparoscopic surgey / 第二军医大学学报

ABSTRACT

Objective: To introduce an improved direct method for first puncture and to study the safety of first puncture in laparoscopic surgery.Methods: Four kinds of techniques were used to perform the first puncture on 4 102 patients.Group A trocar puncture were performed after pneumoperitoneum in 2 492 cases.Group B trocar puncture was directly through the incision of umbilical skin in 798 patients; Group C trocar puncture was directly through the incision of umbilic skin,subcutancous fat and fascia in 387 patients.Group D opened umbilical hole and inserted the trocar shell without puncture in 425 cases.it was a success if entered the abdominal cavity at the first time,it was unsafe if punctured twice and a failure if the needle hadn't entered the abdominal cavity for 3 times or went into the subcutaneous vessels or viscera.Results: There were no vessels and viscera injury during punctures in our study.The puncture results were related to the different methods.Compared with group A, the success rate of group C and D were significantly improved( P 0.05).Success rates of group C and D were significantly higher than that of group A.The success rate was higher in group D than in group C( P