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A new technique in laparoscopic abdominal access (Evsen Method, Modified Veress Technique)
Affiliations- DİCLE UNİVERSİTY, DİYARBAKIR/TURKEY, 21200 DİYARBAKIR, Türkiye
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Abstract
Objectives: The most important step in laparoscopic surgery is to safely establish the pneumoperitoneum, especially since approximately half of the complications occur during the initial entry into the abdomen. There is a distinct need to modify the available methods to reduce therate of adverse events in laparoscopic entry. In this study, a modified Veress technique (MVT) or Evsen method is introduced.The aim of this article was to present a modified Veress technique for establishing the pneumoperitoneum.
Material and methods: The study was conducted at the Dicle University, Faculty of Medicine, Department of Obstetrics and Gynecology, from September 2016 to May 2017. A new laparoscopic entry technique was introduced and compared with the classical Veress technique. A total of 40 cases were included in the study. MVT and the classical Veress method were applied to 26 and 14 patients, respectively.
Results: The pneumoperitoneum was established at the first attempt in 23 (88.5%) MVT patients and in 7 (50%) patients from the classical Veress method group. The number of insufflation attempts to establish a successful pneumoperitoneum was lower using MVT and the difference was statistically significant (p: 0.022). As far as time is concerned, a comparison between the groups revealed that the pneumoperitoneum was established in a statistically significantly shorter time using MVT (p < 0.00).
Conclusions: The modified Veress technique proved to be superior to the classical Veress method for establishing the pneumoperitoneum. Using the new method, the pneumoperitoneum was established after fewer attempts and in a shorter time.
Abstract
Objectives: The most important step in laparoscopic surgery is to safely establish the pneumoperitoneum, especially since approximately half of the complications occur during the initial entry into the abdomen. There is a distinct need to modify the available methods to reduce therate of adverse events in laparoscopic entry. In this study, a modified Veress technique (MVT) or Evsen method is introduced.The aim of this article was to present a modified Veress technique for establishing the pneumoperitoneum.
Material and methods: The study was conducted at the Dicle University, Faculty of Medicine, Department of Obstetrics and Gynecology, from September 2016 to May 2017. A new laparoscopic entry technique was introduced and compared with the classical Veress technique. A total of 40 cases were included in the study. MVT and the classical Veress method were applied to 26 and 14 patients, respectively.
Results: The pneumoperitoneum was established at the first attempt in 23 (88.5%) MVT patients and in 7 (50%) patients from the classical Veress method group. The number of insufflation attempts to establish a successful pneumoperitoneum was lower using MVT and the difference was statistically significant (p: 0.022). As far as time is concerned, a comparison between the groups revealed that the pneumoperitoneum was established in a statistically significantly shorter time using MVT (p < 0.00).
Conclusions: The modified Veress technique proved to be superior to the classical Veress method for establishing the pneumoperitoneum. Using the new method, the pneumoperitoneum was established after fewer attempts and in a shorter time.
Keywords
laparoscopic entry, laparoscopic surgical technique, pneumoperitoneum, Veress needle
About this articleTitle
A new technique in laparoscopic abdominal access (Evsen Method, Modified Veress Technique)
Journal
Issue
Article type
Research paper
Pages
481-484
Published online
2018-09-28
Page views
1808
Article views/downloads
1499
DOI
Pubmed
Bibliographic record
Ginekol Pol 2018;89(9):481-484.
Keywords
laparoscopic entry
laparoscopic surgical technique
pneumoperitoneum
Veress needle
Authors
Mehmet Siddik Evsen
Mehmet Sait Icen
Fatih Mehmet Findik
Senem Yaman Tunc
Elif Ağaçayak
Talip Gul
References (11)- Krishnakumar S, Tambe P. Entry complications in laparoscopic surgery. J Gynecol Endosc Surg. 2009; 1(1): 4–11.
- Philips PA, Amaral JF. Abdominal access complications in laparoscopic surgery. J Am Coll Surg. 2001; 192(4): 525–536.
- Toro A, Mannino M, Cappello G, et al. Comparison of two entry methods for laparoscopic port entry: technical point of view. Diagn Ther Endosc. 2012; 2012: 305428.
- Y-Palmer R. Safety in laparoscopy. J Reprod Med. 1974; 13: 1–5.
- Hasson HM, Rotman C, Rana N, et al. Open laparoscopy: 29-year experience. Obstet Gynecol. 2000; 96(5 Pt 1): 763–766.
- Ahmad G, Gent D, Henderson D, et al. Laparoscopic entry techniques. Cochrane Database of Systematic Reviews. 2015.
- Cornette B, Berrevoet F. Trocar Injuries in Laparoscopy: Techniques, Tools, and Means for Prevention. A Systematic Review of the Literature. World J Surg. 2016; 40(10): 2331–2341.
- Teoh B, Sen R, Abbott J. An evaluation of four tests used to ascertain Veres needle placement at closed laparoscopy. J Minim Invasive Gynecol. 2005; 12(2): 153–158.
- https://www.youtube.com/watch?v=F_5S64U5vIM.
- Kroft J, Aneja A, Tyrwhitt J, et al. Laparoscopic peritoneal entry preferences among Canadian gynaecologists. J Obstet Gynaecol Can. 2009; 31(7): 641–648.
- Lalchandani S, Phillips K. Laparoscopic entry technique—a survey of practices of consultant gynaecologists. Gynecological Surgery. 2005; 2(4): 245–249.
