Abstracts of the 12th National Congress of the Italian Polyspecialistic Society of Young Surgeons (SPIGC)

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 182 KB
• Volume: 70
• Category: Article
• ISSN: 0022-4790
• DOI: 10.1002/(sici)1096-9098(1999)70:4+<62::aid-jso10>3.0.co;2-t

✦ Synopsis

INTRODUCTION:

The reported rate of mortality related to the creation of pneumoperitoneum varies from 0.05 to 0.2%. However, a definite trend not to report such complications exists, and therefore such figures are probably underestimated. The main source of morbidity and mortality during the creation of pneuoperitoneum is due to the injury to major retroperitoneal vessels and/or to hollow viscus. The open approach, first introduced by Hasson in 1971, should prevent nearly all such accidents, but it failed to receive a widespread acceptance in surgical centers (1, 2). We performed a retrospective evaluation of our experience with the open approach to pneumoperitoneum in order to check its safety and to explain the reason of such a phenomenon METHODS: From 1991 to 1997, 1,006 consecutive open laparoscopic procedures were performed by the Authors. RESULTS: Mean operating time for inducing pneumoperitoneum was 4.8 minutes (range: 1.5-16). The procedures performed in obese patients (B.M.I. > 30) averaged 9.5 min. and in the presence of dense periumbilical adhesions averaged 7.2 min. Mean time in the first 50 procedures (5.9 min.) was significantly higher than in the remaining patients (3.8 min.). We did not record any failed attempt. We found 22 (2.2%) complications related to open laparoscopy (Table ).

Complication

First 50 cases Subsequent 956 cases n. (%) n. (%) Umbilical infection 1 (2) 18 (1.8) Subumbilical hernia 1 (2) --Abdominal wall hematoma --1 (0.1) Small bowel injury 1 (2) --TOTAL 3 (6) 19 (1.9) DISCUSSION:

The results of this study confirm that the open approach can be safely performed and is effective in the prevention of major complications after a learning curve of about 50 cases.