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Primary access-related complications with laparoscopy: Comparison of blind and open techniques.

Moberg, Ann-Cathrin LU and Montgomery, Agneta LU (2005) In Surgical Endoscopy 19(9). p.1196-1199
Abstract
Background: Severe or fatal complications attributable to gas embolus, major vascular injury, or visceral injury are rare but have been reported after blind access to the abdominal cavity in laparoscopy. The open access technique has been introduced with the aim to reduce these injuries. This report evaluates access-related complications with both blind and open access techniques in a teaching hospital using standardized techniques for both methods.

Methods: Two groups of patients at different times from a prospective database were compared. A retrospective analysis of 2,297 patients treated using blind access between 1992 and 1996 were compared with 2,066 patients treated using open step-by-step access between 1999 and 2001... (More)
Background: Severe or fatal complications attributable to gas embolus, major vascular injury, or visceral injury are rare but have been reported after blind access to the abdominal cavity in laparoscopy. The open access technique has been introduced with the aim to reduce these injuries. This report evaluates access-related complications with both blind and open access techniques in a teaching hospital using standardized techniques for both methods.

Methods: Two groups of patients at different times from a prospective database were compared. A retrospective analysis of 2,297 patients treated using blind access between 1992 and 1996 were compared with 2,066 patients treated using open step-by-step access between 1999 and 2001 regarding access-related complications. An accreditation program for both techniques was mandatory for the 67 surgeons involved.

Results: No case of gas embolus or major vascular injury was seen in either group. Four cases of visceral injuries (0.17%) in the blind access group and one case (0.05%) in the open group were seen (p = 0.337). All the injuries were recognized and repaired intraoperatively with no further postoperative complications.

Conclusion: Our educational efforts to make both techniques as safe as possible were successful, as evidenced by a minimum of access-related complications. Because no evidence exists to show that the blind access technique is superior in any aspect, the open technique is recommended for access to the abdominal cavity in laparoscopy. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Access-related complications, Open access, Blind access
in
Surgical Endoscopy
volume
19
issue
9
pages
1196 - 1199
publisher
Springer
external identifiers
  • pmid:16132329
  • wos:000232343400007
  • scopus:26844556734
ISSN
0930-2794
DOI
10.1007/s00464-004-2256-6
language
English
LU publication?
yes
id
48d07a80-c944-438d-9663-b46523759f1d (old id 143965)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16132329&dopt=Abstract
date added to LUP
2007-07-26 14:01:58
date last changed
2017-01-01 06:47:16
@article{48d07a80-c944-438d-9663-b46523759f1d,
  abstract     = {Background: Severe or fatal complications attributable to gas embolus, major vascular injury, or visceral injury are rare but have been reported after blind access to the abdominal cavity in laparoscopy. The open access technique has been introduced with the aim to reduce these injuries. This report evaluates access-related complications with both blind and open access techniques in a teaching hospital using standardized techniques for both methods.<br/><br>
Methods: Two groups of patients at different times from a prospective database were compared. A retrospective analysis of 2,297 patients treated using blind access between 1992 and 1996 were compared with 2,066 patients treated using open step-by-step access between 1999 and 2001 regarding access-related complications. An accreditation program for both techniques was mandatory for the 67 surgeons involved.<br/><br>
Results: No case of gas embolus or major vascular injury was seen in either group. Four cases of visceral injuries (0.17%) in the blind access group and one case (0.05%) in the open group were seen (p = 0.337). All the injuries were recognized and repaired intraoperatively with no further postoperative complications.<br/><br>
Conclusion: Our educational efforts to make both techniques as safe as possible were successful, as evidenced by a minimum of access-related complications. Because no evidence exists to show that the blind access technique is superior in any aspect, the open technique is recommended for access to the abdominal cavity in laparoscopy.},
  author       = {Moberg, Ann-Cathrin and Montgomery, Agneta},
  issn         = {0930-2794},
  keyword      = {Access-related complications,Open access,Blind access},
  language     = {eng},
  number       = {9},
  pages        = {1196--1199},
  publisher    = {Springer},
  series       = {Surgical Endoscopy},
  title        = {Primary access-related complications with laparoscopy: Comparison of blind and open techniques.},
  url          = {http://dx.doi.org/10.1007/s00464-004-2256-6},
  volume       = {19},
  year         = {2005},
}