Vilos George A
Department of Obstetrics and Gynecology, St. Joseph's Health Care, The University of Western Ontario, London, Ontario, Canada.
J Minim Invasive Gynecol. 2006 May-Jun;13(3):249-51. doi: 10.1016/j.jmig.2005.12.005.
It is well known that at least 50% of laparoscopic complications occur during the initial entry into the abdomen regardless of the method used. There is evidence that most gynecologists practice the "classic" or closed laparoscopic entry. There is no evidence that the closed entry is more or less dangerous than the other existing methods of entry. Entry-related complications have been minimized by the following three steps: low initial Veres intraperitoneal pressure indicating correct placement of the Veres needle; transient high-pressure pneumoperitoneum before primary trocar/cannula insertion; and visual entry with the Ternamian cannula. Following the above steps, no entry complications have been encountered by the author in more than 3000 consecutive laparoscopies.
众所周知，无论采用何种方法，至少50%的腹腔镜并发症发生在最初进入腹腔的过程中。有证据表明，大多数妇科医生采用“经典”或闭合式腹腔镜进入法。没有证据表明闭合式进入法比其他现有的进入方法更危险或更安全。通过以下三个步骤，与进入相关的并发症已降至最低：初始Veres针腹腔内压力低表明Veres针放置正确；在插入主套管针之前进行短暂的高压气腹；以及使用Ternamian套管进行可视化进入。遵循上述步骤，作者在连续3000多次腹腔镜手术中未遇到任何进入并发症。
