Abstract: Background: The aim of this study was to compare the outcomes of direct trocar entry without prior pneumoperitoneum at umbilical level (DTI) versus veress needle entry for laparoscopic surgeries in terms of injury to abdominal viscera, safety, need for reinsertion of trocar and the time taken from skin incision to the insertion of camera.
Methods: The present study was a prospective study conducted at the Department of General Surgery at Dr. M.K. Shah Medical College & Research Centre & Smt S.M.S. Multispeciality Hospital, Ahmedabad, Gujarat, India. (Faimer School Id: F0006702), a tertiary care hospital, from January 2020 till January 2021. Total of 100 cases were included in the study. All the cases who underwent abdominal laparoscopic surgery during this time duration were taken into account. The patients were divided into two groups bases upon the surgical units in which they were admitted as Group A in which traditional technique of veress needle entry was used for access, and Group B in which direct trocar entry without prior pneumoperitoneum was used. These two groups were compared in terms of the demographic profile, duration of procedure, risk of injuries, safety and various complications which were encountered during the procedure.
Results: Patients in both the groups had similar demographic characteristics. The mean duration of the procedure was significantly shorter in group B (1.74 ± 0.6min) than in group A (4.06 ± 1.2min). No major complications in both groups were encountered. Minor complications were significantly less in group B than in group A.
Conclusion: From our study we conclude with the opinion that direct trocar entry is as safe as prior insufflation of abdomen with the veress needle in a laparoscopic procedure. It is a time saving procedure, reduces the number of blind procedures and eliminates the complications of veress needle entry.
