A Baruah, N Topno, S Ghosh, N Naku, R Hajong, D Tongper, D Khongwar, P Baruah, N Chishi, S Sutradhar
{"title":"在印度东北部一家三级医院进行常规腹腔镜胆囊切除术的患者中，封闭与开放腹腔镜初级腹膜通路技术的安全性和发病率的研究。","authors":"A Baruah, N Topno, S Ghosh, N Naku, R Hajong, D Tongper, D Khongwar, P Baruah, N Chishi, S Sutradhar","doi":"10.1155/2022/1017551","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic cholecystectomy (LC) is the gold standard operation for gallstone disease. Primary port placement into the abdomen is a blind procedure and is challenging with chances of unforeseen complications. The complication rate has remained the same during the past 25 years. Both closed/Veress and open/Hasson's techniques are commonly employed and have their typical indications for use.</p><p><strong>Materials and methods: </strong>This prospective study was carried out in the Department of General Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, from January 2014 to January 2016, with the aim to compare the safety profile of closed/Veress and open/Hasson's methods of access to the abdomen during laparoscopic cholecystectomy (LC). The study had 400 eligible cases undergoing LC who were randomly allotted into 2 groups with 200 cases each: group A: closed/Veress needle method and group B: open/Hasson's method.</p><p><strong>Results: </strong>Closed/Veress and open/Hasson's method of establishing pneumoperitoneum in laparoscopic cholecystectomy is equally safe in terms of major complications. The closed/Veress method gives faster access to the abdomen as compared to the open method (5.62 ± 2.23 minutes and 7.18 ± 2.52 minutes, respectively, <i>p</i> value <0.0001). The open/Hasson's method is associated with more primary port site complications (9/200 vs. 0/200, <i>p</i> value 0.0036) and troublesome intraoperative gas leaks (39/200 vs. 2/200, <i>p</i> value <0.0001). The open technique for primary peritoneal access port for laparoscopic cholecystectomy does not impart any additional benefits in terms of safety and morbidity profile in patients undergoing LC.</p><p><strong>Conclusion: </strong>The closed/Veress method of establishing pneumoperitoneum in laparoscopic cholecystectomy is equally safe in terms of major complications and gives quicker access to the abdomen as compared to the open method.</p>","PeriodicalId":45110,"journal":{"name":"Minimally Invasive Surgery","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2022-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9296326/pdf/","citationCount":"0","resultStr":"{\"title\":\"A Study of the Safety and Morbidity Profile of Closed versus Open Technique of Laparoscopic Primary Peritoneal Access Port in Patients Undergoing Routine Laparoscopic Cholecystectomy at a Tertiary Care Hospital in Northeastern India.\",\"authors\":\"A Baruah, N Topno, S Ghosh, N Naku, R Hajong, D Tongper, D Khongwar, P Baruah, N Chishi, S Sutradhar\",\"doi\":\"10.1155/2022/1017551\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Laparoscopic cholecystectomy (LC) is the gold standard operation for gallstone disease. Primary port placement into the abdomen is a blind procedure and is challenging with chances of unforeseen complications. The complication rate has remained the same during the past 25 years. Both closed/Veress and open/Hasson's techniques are commonly employed and have their typical indications for use.</p><p><strong>Materials and methods: </strong>This prospective study was carried out in the Department of General Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, from January 2014 to January 2016, with the aim to compare the safety profile of closed/Veress and open/Hasson's methods of access to the abdomen during laparoscopic cholecystectomy (LC). The study had 400 eligible cases undergoing LC who were randomly allotted into 2 groups with 200 cases each: group A: closed/Veress needle method and group B: open/Hasson's method.</p><p><strong>Results: </strong>Closed/Veress and open/Hasson's method of establishing pneumoperitoneum in laparoscopic cholecystectomy is equally safe in terms of major complications. The closed/Veress method gives faster access to the abdomen as compared to the open method (5.62 ± 2.23 minutes and 7.18 ± 2.52 minutes, respectively, <i>p</i> value <0.0001). The open/Hasson's method is associated with more primary port site complications (9/200 vs. 0/200, <i>p</i> value 0.0036) and troublesome intraoperative gas leaks (39/200 vs. 2/200, <i>p</i> value <0.0001). The open technique for primary peritoneal access port for laparoscopic cholecystectomy does not impart any additional benefits in terms of safety and morbidity profile in patients undergoing LC.</p><p><strong>Conclusion: </strong>The closed/Veress method of establishing pneumoperitoneum in laparoscopic cholecystectomy is equally safe in terms of major complications and gives quicker access to the abdomen as compared to the open method.</p>\",\"PeriodicalId\":45110,\"journal\":{\"name\":\"Minimally Invasive Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2022-07-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9296326/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Minimally Invasive Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1155/2022/1017551\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Minimally Invasive Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2022/1017551","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
腹腔镜胆囊切除术(LC)是胆结石疾病的金标准手术。初级端口放置到腹部是一个盲目的过程，具有不可预见的并发症的机会的挑战。在过去的25年中，并发症发生率保持不变。封闭/Veress和开放/Hasson技术都是常用的，并且有其典型的使用适应症。材料与方法:本前瞻性研究于2014年1月至2016年1月在西隆东北英迪拉甘地地区卫生与医学科学研究所(NEIGRIHMS)普外科进行，目的是比较腹腔镜胆囊切除术(LC)中封闭/Veress和开放/Hasson入腹方法的安全性。本研究有400例符合条件的LC患者，随机分为2组，每组200例:A组:闭式/Veress针法，B组:开式/Hasson法。结果:腹腔镜胆囊切除术中闭合/Veress法与开放/Hasson法建立气腹在主要并发症方面同样安全。与开放式方法相比，封闭式/Veress方法进入腹部的时间更快(分别为5.62±2.23分钟和7.18±2.52分钟，p值p值为0.0036)，术中气体泄漏更麻烦(39/200 vs. 2/200, p值)。结论:腹腔镜胆囊切除术中采用封闭式/Veress方法建立气腹在主要并发症方面同样安全，与开放式方法相比，进入腹部的时间更快。
A Study of the Safety and Morbidity Profile of Closed versus Open Technique of Laparoscopic Primary Peritoneal Access Port in Patients Undergoing Routine Laparoscopic Cholecystectomy at a Tertiary Care Hospital in Northeastern India.
Introduction: Laparoscopic cholecystectomy (LC) is the gold standard operation for gallstone disease. Primary port placement into the abdomen is a blind procedure and is challenging with chances of unforeseen complications. The complication rate has remained the same during the past 25 years. Both closed/Veress and open/Hasson's techniques are commonly employed and have their typical indications for use.
Materials and methods: This prospective study was carried out in the Department of General Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, from January 2014 to January 2016, with the aim to compare the safety profile of closed/Veress and open/Hasson's methods of access to the abdomen during laparoscopic cholecystectomy (LC). The study had 400 eligible cases undergoing LC who were randomly allotted into 2 groups with 200 cases each: group A: closed/Veress needle method and group B: open/Hasson's method.
Results: Closed/Veress and open/Hasson's method of establishing pneumoperitoneum in laparoscopic cholecystectomy is equally safe in terms of major complications. The closed/Veress method gives faster access to the abdomen as compared to the open method (5.62 ± 2.23 minutes and 7.18 ± 2.52 minutes, respectively, p value <0.0001). The open/Hasson's method is associated with more primary port site complications (9/200 vs. 0/200, p value 0.0036) and troublesome intraoperative gas leaks (39/200 vs. 2/200, p value <0.0001). The open technique for primary peritoneal access port for laparoscopic cholecystectomy does not impart any additional benefits in terms of safety and morbidity profile in patients undergoing LC.
Conclusion: The closed/Veress method of establishing pneumoperitoneum in laparoscopic cholecystectomy is equally safe in terms of major complications and gives quicker access to the abdomen as compared to the open method.
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