Gullà N, Patriti A, Lazzarini F, Tristaino B
Dipartimento di Scienze Chirurgiche, Università degli Studi, Perugia.
Minerva Chir. 2000 May;55(5):371-5.
In laparoscopic surgery, pneumoperitoneum may be obtained either by a blind or an open access technique. These two techniques and the advantages of Hasson technique are compared.
Through January 1998 and May 1999, 262 unselected patients underwent laparoscopic surgery; pneumoperitoneum was obtained with a random technique, while in the patients previously operated on the open technique was always performed. In 161 cases (61.5%) pneumoperitoneum was obtained with Hasson technique and in 101 (38.5%) with Veress technique. All the patients were clinically evaluated after surgery and then after 30-40 days. The complications encountered were always associated with the Veress needle blind access: peritoneal space insufflation in 3 cases, greater omentum insufflation in 3 cases, 4 cases of difficult management and only one case of incisional hernia on the umbilical wound.
Our data confirm that Hasson open technique is safer than Veress blind technique as the risk of severe early and late complications is lower.
The open laparoscopic technique with the Hasson trocar is recommended as it showed to be a quicker, safer and superior technique for obtaining pneumoperitoneum.
在腹腔镜手术中，气腹可通过盲目或开放入路技术获得。对这两种技术以及哈森技术的优势进行了比较。
在1998年1月至1999年5月期间，262例未经挑选的患者接受了腹腔镜手术；气腹通过随机技术获得，而对于先前接受过手术的患者则始终采用开放技术。161例（61.5%）采用哈森技术获得气腹，101例（38.5%）采用韦雷斯技术。所有患者在术后以及30 - 40天后均进行了临床评估。所遇到的并发症均与韦雷斯针盲目入路相关：3例出现腹膜腔充气，3例出现大网膜充气，4例处理困难，脐部伤口仅1例发生切口疝。
我们的数据证实，哈森开放技术比韦雷斯盲目技术更安全，因为早期和晚期严重并发症的风险更低。
推荐使用带有哈森套管针的开放腹腔镜技术，因为它在获得气腹方面显示出更快、更安全且更优越。
