Copeland C, Wing R, Hulka J F
Obstet Gynecol. 1983 Nov;62(5):655-9.
The need for pneumoperitoneum before trocar entry in laparoscopy is evaluated. In over 2000 unselected cases performed in a residency training program from January 1979 to December 1982, three complications of bowel perforation and peritonitis occurred, one despite needle induction of pneumoperitoneum. In entering the abdomen directly with a trocar, critical surgical points are emphasized: adequate relaxation, sharp trocars, adequate skin incision, elevation of the abdominal wall, and insertion of the trocar into the true pelvis. For most patients with no previous abdominal surgery, the authors suggest that this technique offers more clinical security because it does not place reliance on secondary tests but emphasizes concentration entirely upon surgical skill and anatomic knowledge during entry.
评估了腹腔镜检查中在套管针穿刺前建立气腹的必要性。在1979年1月至1982年12月住院医师培训项目中进行的2000多例未经筛选的病例中，发生了3例肠穿孔和腹膜炎并发症，其中1例尽管采用了针式气腹建立方法。在直接用套管针进入腹腔时，强调了关键的手术要点：充分放松、锋利的套管针、足够的皮肤切口、腹壁抬高以及将套管针插入真骨盆。对于大多数既往未行腹部手术的患者，作者认为该技术提供了更高的临床安全性，因为它不依赖辅助检查，而是在进入腹腔过程中完全强调手术技巧和解剖知识。
