Direct Trocar Insertion without Pneumoperitoneum and the Veress Needle in Laparoscopic Cholecystectomy: a Comparative Study

Abstract

Purpose: The purpose of this study is to compare the safety and complications of direct trocar insertion without pneumoperitoneum (DTI) with Veress needle (VN) in laparoscopic cholecystectomy (LC). Methods: We studied 84 patients admitted to our hospital for LC, in a random simple blind design, 42 patients were assigned to DTI and 42 to VN. The variables analysed were: procedure complications, laparoscope insertion time and duration of surgery.

Results: Complication percentages between the groups were significantly different (DTI 2.3% versus VN 23.8%, p = 0.009). The duration of surgery between the two groups was also significantly different (DTI 56 ±31 versus VN 71 ± 28 minutes, p < 0.02). Finally, laparoscope insertion time between the two techniques was significantly different (DTI 1.5 ± 0.5 versus VN 3.0 ± 0.4 minutes p < 0.001).

Conclusions: Our results show DTI to be a safe, efficient, rapid and easily-learned alternative technique, reducing the number of procedure-related complications.

Key Words:

• Laparoscopy
• cholecystectomy
• pneumoperitoneum

Additional information

Notes on contributors

B. Trujillo-Hernández

B. Trujillo-Hernández Calle Gorrión # 14, Colonia Lomas Verdes, CP 28017, MEX-Colima, Colima, Mexico. Tel.: [phone], Fax: [phone], E-mail: [email protected]