Comparison between Creation of Pneumoperitoneum by Open Technique and Closed Technique
DOI:
https://doi.org/10.51985/Keywords:
Laparoscopy, Pneumoperitoneum, Prospective Complications, TrocarAbstract
Objectives: Compare closed (Veress needle) and open (trocar) techniques for pneumoperitoneum in laparoscopic procedures regarding access time, complication rates, and patient outcomes.
Study Design and Setting: 99 patients undergoing laparoscopic procedures were divided into two groups. Group A (closed technique with a veress needle) included 43 patients, and Group B (open technique using a trocar) included 56 patients. The main outcome was access time (minutes), and secondary outcomes included complications like gas leaks, organ injury, vascular injury, hematomas, and site infections. This design intended to compare the efficacy and safety of both techniques. Methodology: Total of 99 patients were included: 43 in Group A (closed method) and 56 in Group B (open method). The primary outcome was access time, while secondary outcomes included complications such as gas leaks, organ injury, vascular injury, hematomas, and site infections. Statistical analysis was conducted to compare the two techniques. Results: Access time was significantly longer in the open method group (7.88 ± 2.76 vs. 6.25 ± 2.55 min, p = 0.03). Open method was associated with a higher incidence of gas leaks (25% vs 7%, p = 0.029), vascular injury (16% vs 2%, p = 0.04), and site infections (25% vs 7%, p = 0.029). No significant difference was observed in organ injuries.
Conclusions: Closed method is more efficient and associated with fewer complications in low-risk cases. Open technique remains a viable alternative for patients with prior abdominal surgery or a higher risk of complications. Individualized patient assessment is essential for selecting optimal approach
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