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Minimally invasive surgery is increasingly being used in veterinary medicine. Laparoscopic procedures have several advantages compared with open surgery. These include the magnification of the field of surgery, reduced post-surgical pain and associated stress, reduced post-operative infection rates, and decreased hospitalization time. The establishment of a pneumoperitoneum is a critical step; however, this procedure can prolong the operation time, and most of the complications associated with laparoscopic surgery have been attributed to the insertion of devices into the abdominal cavity. Two main techniques have been employed to create pneumoperitoneum: the closed-entry method using the Veress needle and the open Hasson technique. The first portal is necessary to start insufflation and, subsequently, to realize the operative channel to insert the laparoscopic instruments into the abdomen. Many authors have compared the time necessary to create the first portal using different techniques in human medicine, but studies on this topic in veterinary medicine are lacking. In the veterinary medicine literature, complications associated with the creation of a pneumoperitoneum and the placement of ports include spleen, bowel, or bladder injuries; pneumothorax; and subcutaneous emphysema. The aim of the present study was to compare the times required for the placement of the first portal and the creation of pneumoperitoneum, and the rates of intraoperative complications using the Veress needle technique (VNT) and the open modified Hasson technique (MHT). The sample population comprised 30 female dogs who underwent laparoscopic ovariectomies. The dogs were randomly organized into two groups and two different entry techniques were used: Veress needle (VNT = group A) and the modified Hasson technique (MHT = group B). Complications related to abdominal entry were classified as major, in cases of organ perforation, and minor, in cases of subcutaneous emphysema and gas leakage. The VNT and MHT required 374.0 s and 242.9 s, respectively, for the placement of the first portal and for establishing pneumoperitoneum ( < 0.05). Their major complications rates were 20% and 0%, respectively ( < 0.05). Their minor complications rates were 20% and 35%, respectively ( < 0.05). No surgical procedures required laparotomy. The MHT was associated with a lower major complication rate and required less time to create the first portal, compared with the Veress needle technique.
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http://dx.doi.org/10.3390/ani11102936 | DOI Listing |
Wiad Lek
August 2025
I.HORBACHEVSKY TERNOPIL NATIONAL MEDICAL UNIVERSITY, TERNOPIL, UKRAINE.
Objective: Aim: To investigate the morphological changes in the costal part of the diaphragm following the induction of pneumoperitoneum at 10 mmHg for varying durations in a rat model, using objective methods.
Patients And Methods: Materials and Methods: To create the model of the experiment, 50 sexually mature rats aged 5-6 months and weighing (225.0±20.
JSLS
May 2025
Frauenklinik an der Elbe, Hamburg, Germany. (Drs. Buchweitz and Hackethal).
Background And Objectives: The LevaLap 1.0 (Core Access Surgical Technologies, Atlanta, GA) was designed to promote safer, more stable, and more predictable abdominal access when using the Veress needle for insufflation. We report on the first postmarket clinical study (PMCF) assessing experience with the use of the LevaLap 1.
View Article and Find Full Text PDFObstet Gynecol
April 2025
Department of Gynecologic Surgery and Obstetrics, Tripler Army Medical Center, Honolulu, Hawaii.
Objective: The primary objective of this project is to develop a low-budget simulation model to supplement laparoscopic entry technique training.
Project Summary: The most common methods of laparoscopic entry are direct entry with optical trocar visualization, Veress needle insufflation before direct entry, and open entry using a Hasson trocar. There is no established method that is universally considered superior to the others, and similar outcomes are seen across all methods in terms of major adverse outcomes such as vascular or visceral injury.
Objective: In laparoscopic surgery, initial entry into the abdomen becomes more risky in patients with a history of abdominal surgery. In such cases, initial entry is usually performed with a Veress needle via Palmer's point (PP). However, it is associated with an increased failure rate, especially in obese patients.
View Article and Find Full Text PDFJ Robot Surg
January 2025
Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, 1425 Madison Ave, New York, USA.
Robotic-assisted surgery offers several advantages over traditional methods, such as reduced blood loss and fewer complications. Establishing pneumoperitoneum is a critical step, with two primary techniques: the Veress needle (closed) and the Hasson (open) technique. Despite extensive studies in laparoscopic surgery, limited data exist regarding their use in robotic surgery.
View Article and Find Full Text PDF