Byron J W, Markenson G, Miyazawa K
Tripler Army Medical Center, Honolulu, Hawaii.
Surg Gynecol Obstet. 1993 Sep;177(3):259-62.
Two hundred and fifty-two women scheduled to undergo laparoscopy were randomly assigned to a Verres needle or direct insertion group. The groups were similar with respect to incidence of obesity, prior surgical treatment, indication for operation and level of training of the surgeon performing the procedure. There were no major complications associated with either technique. Minor complications (preperitoneal insufflation, failed entry or more than three attempts necessary to enter the peritoneal cavity with the trocar) were significantly more frequent (p < 0.05) in the Verres needle technique group. One hundred and thirteen of these patients underwent sterilization procedures. The mean times for performance of the laparoscopic procedure using the direct insertion and Verres needle techniques was 15.3 and 19.6 minutes, respectively. The time saved using the direct insertion technique is explained by a significant (p < 0.01) reduction in the mean laparoscope insertion time, which was 2.2 minutes and 5.9 minutes for the direct insertion and Verres needle techniques, respectively. We prefer the direct insertion technique for trocar placement because it has fewer minor complications and requires less operating time.
252名计划接受腹腔镜检查的女性被随机分为Verres针组或直接插入组。两组在肥胖发生率、既往手术治疗情况、手术指征以及实施该手术的外科医生的培训水平方面相似。两种技术均未出现重大并发症。Verres针技术组的轻微并发症（腹膜前充气、穿刺失败或使用套管针进入腹腔需要三次以上尝试）明显更常见（p<0.05）。其中113名患者接受了绝育手术。使用直接插入技术和Verres针技术进行腹腔镜手术的平均时间分别为15.3分钟和19.6分钟。直接插入技术节省的时间是由于平均腹腔镜插入时间显著缩短（p<0.01），直接插入技术和Verres针技术的平均腹腔镜插入时间分别为2.2分钟和5.9分钟。我们更倾向于使用直接插入技术放置套管针，因为它的轻微并发症较少且手术时间较短。
