Direct Trocar Insertion without Previous Pneumoperitoneum in Laparoscopic Surgery
Author(s): BushraTasneem*, Aisha Tasneem, Rahila Imtiaz, Aqsa Ismail, Nida Ahmed, Iqra Mustaqeem, Ahsan Ali Siddiqui and Sana Bilar
Objectives: The purpose of this study was to assess the safety, feasibility, benefits and risks of direct trocar insertion (DTI) in various laparoscopic procedures without previous Pneumoperitoneum Methodology: This prospective observational study was conducted at the department of surgery Abbasi Shaheed Hospital Karachi June 2015 to June 2021. Patients that underwent various laparoscopic procedures and admitted through OPD and emergency were included. All patients of either gender in-between 15 to 70 years, undergoing any laparoscopic surgery were included having direct trocar insertion (DTI) without any previous pneumoperitoneum. Patients with history of surgeries or current abdominal tuberculosis, appendicular lump, peritonitis, unfit for anesthesia (ASA III or above) or any systemic disease were excluded. SPSS version 23.0 was used for data analysis. For qualitative data, frequency and percentages were reported whilst for quantitative data, mean and standard deviation was recorded Results: From total of 1913 patients, 1900 underwent laparoscopic cholecystectomy, 08 laparoscopic appendectomies while 05 patients had undergone laparoscopic ovarian cystectomy. 1668 (87.2%) patients were females while 245 (12.8%) were males.DTI was found to be successful in all 100% of patients without any intra-abdominal or visceral injuries either major or minor. No leakage of gas was reported in any patient. 27 (1.4%) patients were reported to develop abdominal wall haemorrhage while 36 (1.9%) patients developed wound infection. Conclusion: This study suggests that DTI is a faster, safer and more reliable alternative to the traditional technique for establishment of pneumoperitoneum and should be used routinely.