London, ON.
Toronto, ON.
J Obstet Gynaecol Can. 2021 Mar;43(3):376-389.e1. doi: 10.1016/j.jogc.2020.12.012. Epub 2020 Dec 26.
To evaluate the benefits and risks of laparoscopic surgery and provide clinical direction on entry techniques, technologies, and their associated complications in gynaecological surgery.
All patients, including pregnant women and women with obesity, undergoing laparoscopic surgery for various gynaecological indications.
The laparoscopic entry techniques and technologies reviewed in formulating this guideline included the closed (Veress needle-pneumoperitoneum-trocar) technique, direct trocar insertion, open (Hasson) technique, visual entry systems, and disposable shielded and radially expanding trocars.
Implementation of this guideline should optimize decision-making in the selection of entry technique for laparoscopic surgery.
We searched English-language articles from September 2005 to December 2019 in PubMed/MEDLINE, Embase, Science Direct, Scopus, and Cochrane Library using the following MeSH search terms alone or in combination: laparoscopic entry, laparoscopy access, pneumoperitoneum, Veress needle, open (Hasson), direct trocar, visual entry, shielded trocars, radially expanded trocars, and laparoscopic complications.
The authors rated the quality of evidence and strength of recommendations using the Canadian Task Force on Preventive Health Care approach (Appendix A).
Surgeons performing laparoscopic gynaecological surgery.
RECOMMENDATIONS.
评估腹腔镜手术的益处和风险，并为妇科手术的入路技术、技术及其相关并发症提供临床指导。
所有接受腹腔镜手术的患者，包括孕妇和肥胖患者，用于各种妇科适应证。
制定本指南时回顾的腹腔镜入路技术和技术包括闭合（Veress 针-气腹-套管）技术、直接套管插入、开放（Hasson）技术、可视入路系统以及一次性屏蔽和放射状扩张套管。
本指南的实施应优化腹腔镜手术入路技术选择的决策。
我们在 PubMed/MEDLINE、Embase、Science Direct、Scopus 和 Cochrane Library 中使用以下 MeSH 搜索词单独或组合搜索了 2005 年 9 月至 2019 年 12 月的英文文章：腹腔镜入路、腹腔镜进入、气腹、Veress 针、开放（Hasson）、直接套管、可视入路、屏蔽套管、放射状扩张套管和腹腔镜并发症。
作者使用加拿大预防保健工作组方法（附录 A）对证据质量和推荐强度进行了评级。
进行妇科腹腔镜手术的外科医生。
建议。
