Wolthuis Albert M
Department of Abdominal Surgery, University Hospital Leuven, Leuven, Belgium.
J Laparoendosc Adv Surg Tech A. 2019 Aug;29(8):1023-1026. doi: 10.1089/lap.2019.0243. Epub 2019 May 29.
Every laparoscopic procedure starts with the creation of a pneumoperitoneum. The open trocar introduction and the use of a Veress needle (VN) are the two most frequent techniques used. The aim of this study was to evaluate safety of the techniques used to create pneumoperitoneum in laparoscopic abdominal surgery by Belgian minimally invasive surgeons. This is a prospective study including all consecutive patients undergoing a laparoscopic surgical procedure for a 2-month period. Primary endpoint was access-related problems during creation of a pneumoperitoneum. Access-related problems were registered using a special smartphone application, facilitating data recording and patient registration. Overall, 9 out of 212 invited surgeons (4.2%) actively registered patients during the study period. A total number of 342 patients were included with 6 access-related problems (1.8%) and conversion to open surgery was necessary in 16 patients (4.7%). Most reported access-related problem was failure to establish a pneumoperitoneum secondary to insufflation of the omentum. There were no major access-related complications. There was no conversion in the group of patients who had an access-related problem. VN entry to create a pneumoperitoneum is safe. In a short study period, gathering data by surgeons willing to participate in a snapshot study is easy and facilitated by a web-based application.
每台腹腔镜手术都始于气腹的建立。开放式套管针置入和使用韦雷氏针（VN）是两种最常用的技术。本研究的目的是评估比利时微创外科医生在腹腔镜腹部手术中用于建立气腹的技术的安全性。这是一项前瞻性研究，纳入了连续两个月内接受腹腔镜手术的所有患者。主要终点是气腹建立过程中与穿刺相关的问题。使用一款特殊的智能手机应用程序记录与穿刺相关的问题，以方便数据记录和患者登记。总体而言，在研究期间，212名受邀外科医生中有9名（4.2%）积极登记了患者。共纳入342例患者，其中6例出现与穿刺相关的问题（1.8%），16例患者（4.7%）需要转为开放手术。报告最多的与穿刺相关的问题是由于大网膜充气导致气腹建立失败。没有出现严重的与穿刺相关的并发症。出现与穿刺相关问题的患者组中没有转为开放手术的情况发生。通过VN穿刺建立气腹是安全可行 的。在较短的研究期间内，愿意参与快速研究的外科医生收集数据很容易，并可通过基于网络 的应用程序来协助完成。
