Hiremath Srikantaiah Chandra Sekhariah, Ahmed Zameer
Department of General Surgery, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
Surg J (N Y). 2022 Sep 2;8(3):e239-e244. doi: 10.1055/s-0042-1756182. eCollection 2022 Jul.
The main challenge in laparoscopic surgery is creating pneumoperitoneum using various surgical techniques. Every procedure has its own advocates. The aim of this study was to determine the cosmetic outcomes of the two of the major surgical techniques (open-Hasson technique versus closed-Veress technique) used in laparoscopic surgery. This was a prospective, observational, comparative study conducted from October 2017 to September 2018 in 132 patients, who presented to our center and fulfilled our selection criteria. For all the patients, pneumoperitoneum was performed using either open (Hasson) or closed technique (Veress). A database was created for all the patients and the technique dependent cosmetic outcomes were assessed and reported. There were a total of 66 patients in each group (open and closed). The mean age of the open group was 51.56±11.42 years and closed group was 54.36±14.78 years, respectively. The major comorbidities found in both the groups were diabetes mellitus (6/66, group A; 7/66, group B) and hypertension (3/66, group A; 4/66, group B). In open group, umbilical (58/66, =0.001) and in closed group infraumbilical (35/66, =0.001) were the most commonly used incisions. As benefits outweigh the risks, the better cosmetic outcomes were observed in patients underwent closed technique over open technique ( <0.05).
腹腔镜手术的主要挑战在于运用各种手术技术建立气腹。每种手术方法都有其支持者。本研究的目的是确定腹腔镜手术中两种主要手术技术（开放哈森技术与闭合韦雷斯技术）的美容效果。
这是一项前瞻性、观察性、对比性研究，于2017年10月至2018年9月对132例符合我们选择标准并前来本中心就诊的患者进行。所有患者均采用开放（哈森）或闭合技术（韦雷斯）建立气腹。为所有患者建立了一个数据库，并对与技术相关的美容效果进行了评估和报告。
每组（开放组和闭合组）各有66例患者。开放组的平均年龄为51.56±11.42岁，闭合组为54.36±14.78岁。两组中发现的主要合并症均为糖尿病（A组6/66；B组7/66）和高血压（A组3/66；B组4/66）。开放组最常用的切口是脐部（58/66，P = 0.001），闭合组是脐下（35/66，P = 0.001）。
由于益处大于风险，接受闭合技术的患者比接受开放技术的患者美容效果更好（P < 0.05）。
