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Initial Laparoscopic Access Using an Optical Trocar Without Pneumoperitoneum Is Safe and Effective in the MorbidlyObese

^* To whom correspondence should be addressed. E-mail: CamposG{at}surgery.ucsf.edu.

	Abstract

Obtaining access to the peritoneal cavity in laparoscopic surgery is more difficult in morbidly obese people. The aim of this study was to examine the safety and efficacy of accessing the peritoneal cavity using an optical, bladeless trocar without previous pneumoperitoneum in morbidly obese patients. The patients’ characteristics and outcomes with consecutive and preferential use of an optical, bladeless, first trocar insertion without previous pneumoperitoneum in morbidly obese patients (body mass index > 35 kg/m²) was reviewed. A total of 208 morbidly obese patients were included. The trocar insertion technique was used in 196 patients. No bowel or major abdominal vessel injuries occurred. Ninetyeight patients (50%) had previous abdominal operations. Trocar-related injuries occurred in 3 patients: a superficial mesenteric laceration in 2 and a laceration of a greater omentum vessel in 1. The direct first trocar insertion technique provides safe entry into the peritoneal cavity in morbidly obese patients.

First published on May 13, 2008, doi:10.1177/1553350608317354

Surgical Innovation 2008;15:126.

A more recent version of this article appeared on June 1, 2008


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