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Latif's point: A new point for Veress needle insertion for pneumoperitoneum in difficult laparoscopy.
Abd Ellatif, Mohamed E; Ghnnam, Wagih M; Abbas, Ashraf; Basheer, Magdy; Dawoud, Ibrahim; Ellaithy, Ramadan.
Afiliación
  • Abd Ellatif ME; Department of Surgery, Mansoura University Hospital, Mansoura, Egypt.
  • Ghnnam WM; Department of Surgery, Hafr Albatin Central Hospital, Hafr Albatin, Saudi Arabia.
  • Abbas A; Department of Surgery, Mansoura University Hospital, Mansoura, Egypt.
  • Basheer M; Department of Surgery, Mansoura University Hospital, Mansoura, Egypt.
  • Dawoud I; Department of Surgery, Mansoura University Hospital, Mansoura, Egypt.
  • Ellaithy R; Department of Surgery, Mansoura University Hospital, Mansoura, Egypt.
Asian J Endosc Surg ; 11(2): 133-137, 2018 May.
Article en En | MEDLINE | ID: mdl-28856845
ABSTRACT

INTRODUCTION:

Creating pneumoperitoneum is the most challenging step during laparoscopy. The periumbilical area is the classic site for Veress needle insertion. We adopted a new access point for peritoneal insufflation.

METHODS:

We introduced a new point for Veress needle insertion to create pneumoperitoneum during difficult laparoscopic procedures. The needle is placed between the xiphoid process and the right costal margin, and it then proceeds toward the patient's right axilla. We collected data to compare using this new method of peritoneal insufflation with using Palmer's point for pneumoperitoneum.

RESULTS:

Since 2013, we have used this new technique in 570 patients (first group) and Palmer's point in 459 patients (second group). Among these patients, 196 patients (20%) had had previous abdominal operations, 98 patients (10%) had irreducible ventral hernia, and 735 patients (70%) were morbidly obese. The two groups were comparable in terms of patient characteristics. The mean time to create pneumoperitoneum in the first group was 0.8 ± 0.002 min compared to 1.08 ± 0.007 min in the second group (P ≤ 0.5). The mean number of punctures was 1.57 ± 1.02 in the first group compared to 2.9 ± 1.5 in the second group (P≤ 0.5); in the first group, 97% were successful on the first attempt entry, whereas this figure was 91% in second group. In the first group, the liver was punctured in 13 patients without any further complications; no other viscera were punctured. In the second group, gastric puncture occurred in 5 cases, transverse colon in 2 cases, and omental injury in 12 cases.

CONCLUSION:

This new access point may represent a safe, fast, and easy way to create pneumoperitoneum, as well as a promising alternative to Palmer's point in patients who are not candidates for classic midline entry.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Peritoneo / Neumoperitoneo Artificial / Laparoscopía Tipo de estudio: Observational_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Asian J Endosc Surg Año: 2018 Tipo del documento: Article País de afiliación: Egipto

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Peritoneo / Neumoperitoneo Artificial / Laparoscopía Tipo de estudio: Observational_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Asian J Endosc Surg Año: 2018 Tipo del documento: Article País de afiliación: Egipto