Demonstration of Safe Entry Techniques for Laparoscopy

Abstract

To demonstrate different techniques, and detail the considerations for obtaining primary laparoscopic access in gynecologic surgery. Video demonstration of the techniques with narrated discussion of each method. The methods for primary entry in laparoscopy vary by location and technique [1,2]. There are inherent risks with any mode of primary entry, and the risks are also specific to each technique [3-6]. The choice for primary entry depends on the patient's anatomy, surgical history, pathology, and surgeon preference [1,2]. This video reviews considerations for choosing the safest entry point and tips for proper entry technique [4,7-10]. The entry sites reviewed include the umbilicus, left upper quadrant, right upper quadrant, and supraumbilical [11]. The entry technique can be either open (Hasson), closed (Veress), or by direct laparoscopic visualization [9,10,12-14]. No single laparoscopic entry technique is superior [3]. The safest and most successful entry method will vary by case characteristics and surgeon training.