Mehmet Akif TÜRKOĞLU, Zeynep KABLAN

Laparoskopik Cerrahide İlk Trokar İçin Basit Açık Giriş Tekniği

Laparoskopik cerrahinin en önemli aşamalarından biri ilk trokarın yerleştirilmesidir. Laparoskopik cerrahide abdomene giriş fazı, özellikle Veress iğnesi veya trokar kör yerleştirildiğinde, birtakım fatal komplikasyonlara neden olabilir. İlk giriş sırasında oluşan komplikasyonlar, operasyonun seyrini belirleyebilir. Ayrıca ilk trokarın geleneksel açık teknikle yerleştirilmesi gaz kaçağı riskini artırır ve zaman kaybına sebep olabilir. Son zamanlarda, laparoskopik cerrahi sırasında kolay ve güvenli bir ilk trokar giriş yöntemi kullanmaktayız. Bu yazıda bu basit açık tekniğimizi sunmayı amaçladık.

A Simple Open Entry Technique for the Initial Trocar in Laparoscopic Surgery

The insertion of the first trocar is one of the most important steps in laparoscopic surgery. Abdominal entry phase in laparoscopic surgery may result in some fatal complications, especially when a Veress needle or a trocar is inserted blindly. Complications during initial entry can determine the course of operation. Furthermore, first trocar entry with traditional open technique is compromised by the leakage of gas and can be time consuming. Recently, we use an easy and safety first trocar insertion technique during laparoscopic surgery. In this paper, we aimed to present this simple open technique.

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Ahmad G, Gent D, Henderson D, et al. Laparoscopic entry techniques. Cochrane Database Syst Rev. 2015;31;8:CD006583.
Simforoosh N, Basiri A, Ziaee SA, et al. Major vascular injury in laparoscopic urology. JSLS 2014;18.
Pryor KP, HurdWW. Modified open laparoscopy using a 5- mm laparoscope. Obstet Gynecol. 2016;127:535-538.
Zaraca F, Catarci M, Gossetti F, et al. Routine use of open laparoscopy: 1,006 consecutive cases. J Laparoendosc Adv Surg Technol. 1999;9:75-80.
Kassir R, Blanc P, Lointier P, et al. Laparoscopic entry techniques in obese patient: Veress needle, direct trocar insertion or open-entry technique? Obes Surg. 2014;24:2193-2194.
Vilos GA. The ABCs of a safer laparoscopic entry. J Minim Invasive Gynecol. 2006;13:249-251.
Jiang X, Anderson C, Schnatz PF. The safety of direct trocar versus Veress needle for laparoscopic entry: a meta-analysis of randomized clinical trials. J Laparoendosc Adv Surg Tech A. 2012;22:362-70.
Uranues S, Ozkan OV, Tomasch G. Safe and easy access technique for the first trocar in laparoscopic surgery. Langenbecks Arch Surg. 2016;401:909- 912.
Carlson WH, Tully G, Rajguru A, Burnett DR, Rendon RA. Cameraless peritoneal entry in abdominal laparoscopy. J Soc Laparoendosc Surg. 2012;16:559-563.
Angioli R, Terranova C, De Cicco NC, et al. A comparison of three different entry techniques in gynecological laparoscopic surgery: a randomized prospective trial. Eur J Obstet Gynecol Reprod Biol. 2013;171:339-342.
Bedaiwy MA, Zhang A, Henry D, et al. Surgical anatomy of supraumbilical port placement: implications for robotic and advanced laparoscopic surgery. Fertil Steril. 2015;103:e33.