Is there any difference between the distances created by towel clamp lifting and towel clamp plus manual lifting of the anterior abdominal wall for direct trocar entry in laparoscopic gynecologic surgery? A prospective interventional study
Journal Title: UNKNOWN - Year 2017, Vol 18, Issue 4
Abstract
Objective Most surgeons prefer to perform anterior abdominal wall lifting during abdominal entry to avoid damage to intestines or main vessels. Anterior abdominal wall lifting is assumed to prevent vital organ injuries by creating an adequate distance prior to entry into the peritoneal cavity. In this study, we compared the distance created for trocar entry into the peritoneal cavity with towel clamp lifting and towel clamp plus manual elevation of the anterior abdominal wall. Materials and Methods Forty patients who underwent various laparoscopic procedures were enrolled. The study was performed in two steps: first the anterior abdominal wall was lifted using towel clamps (TC group), next the anterior abdominal wall was lifted via maximal manual elevation from the lower abdomen in addition to towel clamps (TCM group). The insertion distance of a plastic ruler into the abdomen was measured from the parietal peritoneum to the intra-abdominal structure in both groups. Results There was a statistically significant difference between the two groups (TC group 3.9±1.5 cm vs. TCM group 4.5±1.5 cm, p<0.001). Correlation analysis of the relationship of distance with BMI in the study groups revealed a strong negative linear correlation [TC group vs. body mass index (BMI); r=-0.719, p<0.001 and TCM group vs. BMI, r=-0.749, p<0.001]. Correlation analysis of the relationship between the study groups and parity number revealed a weak negative linear correlation (TC group vs. parity number, r=-0.071, p=0.76 and the TCM group vs. parity number, p=0.61), which did not reach statistical significance. Conclusion The recruitment of both towel clamps and manual elevation in anterior abdominal wall lifting provides significantly greater distance for trocar entry in laparoscopic surgery.
Authors and Affiliations
Taner A. Usta, Tolga Karacan, Evrim Ebru Kovalak, Ulviye Hanlı, M. Murat Naki
Keywords
Related Articles
- EP ID EP380042
- DOI 10.4274/jtgga.2016.0203
- Views 30
- Downloads 0
Results of an internal audit on the survival of patients with uterine sarcoma
Objective: In the last 5 years there has been much discussion about the surgical procedure for uterine fibroids, and essentially, also uterine sarcoma. Still there exists no reliable presurgical diagnostic tool to differ...
Does the presence of endometriosis cause a challenge for transvaginal oocyte retrieval? A comparison between patients with and without endometriosis
Objective: The aim of the study was to compare patients with and without endometriosis regarding performance rates, difficulties, and complications associated with transvaginal oocyte retrieval (TVOR) procedures. Materia...
Risk factors for appendiceal involvement in women with epithelial ovarian cancer
Objective: To evaluate the risk factors for appendiceal involvement in women with epithelial ovarian cancer (EOC) who underwent appendectomy at the time of initial surgery. Material and Methods: Patients with a final di...
The effect of the pooling method on the live birth rate in poor ovarian responders according to the Bologna criteria
Objective: Pooling is an alternative method to achieve in vitro fertilization outcomes. This study was to investigate the effect of pooling method on pregnancy outcomes in poor responder patients according to Bologna cri...
Fertility sparing approach as the standard of care in young patients with immature teratomas
Immature teratomas are quite rare tumors arising in young women. They are usually diagnosed in early stage and grade and have a good prognosis. In these young patients, fertility-sparing management is suggested as the st...