Rahman M M, Mamun A A
Department of Surgery, Mymensingh Medical College Hospital.
Mymensingh Med J. 2003 Jan;12(1):45-7.
The study was designed to assess the feasibility of direct trocar technique for accessing the abdominal cavity for operative laparoscopy. A retrospective review of 1500 patients who underwent Laparoscopic cholecystectomy in Mymensingh Medical College Hospital and a private hospital between January 1999 and July 2002 was done. The transumbilical direct trocar entry method was used in 1375, the veress needle insertion technique was employed in 106 patients and open laparoscopy was used in 19 patients. Six (0.4%) Major complications occurred; 4 enterotomy and 2 omental herniation. All the enterotomy was related to primary access. Three (0.22%) during direct trocar entry method and another by open laparoscopy method. The bowel was repaired. Two patients had omental herniation through the umbilical port site related to open laparoscopy method which were repaired. Based on our experience the direct trocar technique is a safe approach to abdominal entry for laparoscopic surgery without prior pneumoperitoneum.
本研究旨在评估直接套管针技术用于腹腔镜手术进入腹腔的可行性。对1999年1月至2002年7月期间在迈门辛医学院医院和一家私立医院接受腹腔镜胆囊切除术的1500例患者进行了回顾性研究。1375例采用经脐直接套管针穿刺法，106例采用韦雷斯针穿刺技术，19例采用开放式腹腔镜手术。发生了6例（0.4%）严重并发症；4例肠切开术和2例网膜疝。所有肠切开术均与初次入路有关。3例（0.22%）发生在直接套管针穿刺法过程中，另1例通过开放式腹腔镜手术方法发生。肠管得到修复。2例患者因开放式腹腔镜手术方法出现网膜通过脐部穿刺孔疝出，均进行了修复。根据我们的经验，直接套管针技术是一种无需预先建立气腹即可安全进入腹腔进行腹腔镜手术的方法。
