The feasibility of open laparoscopy in gynecologic-oncologic patients.

Gynecologic-oncologic patients are at increased risk for complications with closed laparoscopy. Open laparoscopy eliminates the steps of blind insufflation and trocar insertion. This study is the first large series of open laparoscopies to assess the feasibility and safety of the open laparoscopy technique in patients with gynecologic malignancies. We performed 90 open laparoscopies in 89 oncologic patients with previous major surgery (65%) and/or radiotherapy (17%) or a large omental cake (18%). Complications due to the laparoscopic access technique occurred in one patient (1%) for whom a laparotomy was performed for a small bowel perforation. The incidence of complications of the open laparoscopy technique (1%) is favorable compared to the complication rate of closed laparoscopy in gynecologic-oncologic patients. It is concluded that open laparoscopy is a safe and feasible technique in gynecologic-oncologic patients.