8414 Jain Point a Viable Entry Port in Obese Patients with and without Previous Surgery

Abstract

<h3>Study Objective</h3> To study the safety and efficacy of Jain Point as first blind entry port in obese patients with and without previous surgery. <h3>Design</h3> Retrospective analysis of 1233 cases done from January 2011 to April 1, 2022, done in a tertiary care center. <h3>Setting</h3> Patients in dorsal lithotomy position, surgery done under GA. <h3>Patients or Participants</h3> We had 1233 patients who were in BMI more than ≥30kg/m². Out of these 866 patients were between ≥30 – 35 kg/m², 273 patient between ≥35 - 40kg/m², and 94 patients were morbidly obese with BMI more than ≥40 kg/m^2. One third of the cases 36% (443) had previous surgeries open or laparoscopy. <h3>Interventions</h3> Jain Point has been designed to suit first blind entry in obese patients to avoid Major Retroperitoneal Vessels, viscera, adhesions and bowel as it lies in left paraumbilical region, 10 – 13 cm from the umbilicus. It is on a vertical line 2.5 cm medial to ASIS at level of umbilicus. We made entry in the study group of 1233 patients by Jain Point by Veress needle first. Long Veress needle is inserted in a vertical direction without needing to change the direction as in umbilical approach. We introduce 10 mm telescope under the vision of 5 mm telescope avoiding any adhesions or bowel. <h3>Measurements and Main Results</h3> All cases were entered through Jain Point by Veress first. There was some preperitoneal insufflation due to increased abdominal wall thickness which was tided over by longer trocars. No major vascular injury or bowel injury was noted, even in case of previous surgeries. <h3>Conclusion</h3> Jain Point is a viable option for first blind port entry in obese patients, with or without previous laparoscopy or open surgery.