January - March 2021

A Randomised Comparative Study Between Direct Trocar Insertion Verus Veress Needle Technique For Creating Pneumoperitoneum In Laproscopic Cholecystectomy

Rakesh Kaul1, Gopal Sharma2*, Tariq P Azad3, Sandeep Bhat4, Barinder Kumar5, Nivedita Prashar6, Vivek Gorkha7

1,7Pg Student, 2MBBS, Ms Senior Resident, 3MBBS, Ms, Professor, 4MBBS, Ms Lecturer, 5MBBS, Ms, Senior Resident,Department Of Surgery, Govt Medical College, Jammu, 6MBBS, Md, Medical Officer, Smgs Hospital, Govt Medical College, Jammu 


BACKGROUND: The ability to establish pneumoperitoneum has long been regarded as the integral first step to any successful laparoscopic procedure. Direct trocar insertion (DTI) is one of the safe and an effective alternative to Veress needle insertion, Open access (Hassan’s technique) and Visual entry systems (disposable Optic trocars and Endotip visual cannula) in laparoscopic surgery for creating pneumoperitoneum. The purpose of this study is to compare the safety and complications of Direct trocar insertion (DTI) with Veress needle (VN) in Laparoscopic Cholecystectomy (LC). METHODS: The present study was conducted in the Postgraduate Department of Surgery, GMC Jammu over a period of one year with effect from 1st November 2014 to 31st October 2015. The study was conducted on 100 patients who underwent laproscopic cholecystectomy. Patients were divided into two groups with 50 patients in each group .In group A, Direct trocar insertion was carried out while in group B, veress needle technique was used. The variables analyzed were time taken to create pneumoperitoneum, safety and procedure related complications. RESULTS: In both the groups, almost equal number of people were suffering from co morbid conditions, 34% in Veress technique and 30% in Direct trocar technique. Both the techniques were able to create pneumoperitoneum in all patients; therefore there was no conversion of procedure to laparotomy in both the groups. The mean time taken (in minutes) to induce pneumoperitoneum in VN technique was 6.80±1.36 minutes where as in DT technique mean time was 3.18±0.66 minutes (p value= 0.001). Minor complications were more in Veress technique than in Direct trocar insertion. There was no major complication in both the groups. CONCLUSIONS: Direct trocar insertion is a fast, safe and reliable alternative to traditional techniques of primary port placement in laparoscopic procedures for creation of pnuemoperitoneum.
Keywords: Laparoscopy,Pneumoperitoneum, Direct trocar insertion (DTI), Veress needle (VN).

Keywords: A Randomised Comparative

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