Laparoscopic entry techniques
Abstract
Laparoscopy is a very common procedure in gynaecology. Complications associated with laparoscopy are often related to entry. The life-threatening complications include injury to the bowel, bladder, major abdominal vessels, and anterior abdominal-wall vessel. Other less serious complications can also occur, such as post-operative infection, subcutaneous emphysema and extraperitoneal insufflation. There is no clear consensus as to the optimal method of entry into the peritoneal cavity. The objective of this study was to compare the different laparoscopic entry techniques in terms of their influence on intra-operative and post-operative complications. This review has drawn on the search strategy developed by the Menstrual Disorders and Subfertility Group. In addition MEDLINE and EMBASE were searched through to July, 2007. Randomised controlled trials were included when one laparoscopic primary-port-entry technique was compared with another. Data were extracted independently by the first two authors. Differences of opinion were registered and resolved by the fourth author. Results for each study were expressed as odds ratio (Peto version) with their 95% confidence intervals. The 17 included randomised controlled trials concerned 3,...Continue Reading
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