Abstract
The Jain point entry is based on the concept of non-umbilical entry to avoid sudden catastrophic injury to major retroperitoneal vessels, viscera, adhesions and bowel which could happen before the start of procedure by blind umbilical entry. To study the safety and efficacy of a novel first non-umbilical blind entry port. Tertiary referral centre for advanced laparoscopic surgeries with active training and fellowship programs. A large retrospective study of 7802 cases done at Vardhman Infertility & Laparoscopy Centre from January 2011 to December 2020. In all cases, first blind entry was by veress needle and 5 mm trocar and telescope through a non-umbilical port, The Jain point, irrespective of BMI, large masses, lax abdomen, previous surgery and complex situations. Patients’ demographic profile, types of surgeries performed and entry-related complications were recorded and analysed. Mean age of patients was 33 years with BMI ranging from 12.66 to 54.41 kg/m2. Thus, Jain point can be applicable for all ranges of BMI, all types of surgeries from simple to complex and large masses. Entry related minor complications were in 3.4% cases while major complication involving bowel occurred in one case. No case of injury to major retro-peritoneal vessel was seen. Jain point entry is a novel, first blind 5 mm non-umbilical, entry technique in a variety of surgeries and previous scars and patients with wide range of BMI. It has a short learning curve and continues as main ergonomic working port.
Highlights
The aim of this study is to introduce the concept of nonumbilical entry [1] to avoid catastrophic complications which could be associated with first blind umbilical entry [2]
This study presents a novel, non-umbilical, first blind 5 mm entry port through Jain point in large number of different types of laparoscopic surgeries in a routine manner with the aim of avoiding catastrophic complications related to entry
We have demonstrated Jain point in several live surgery workshops and conferences done for the associations like SELSI (Society for Endoscopic and Laparoscopic Surgeons of India) and AMASI (Association of Minimal Access Surgeons of India) which have membership of gynaecologists, urologists, general surgeons and bariatric surgeons
Summary
The aim of this study is to introduce the concept of nonumbilical entry [1] to avoid catastrophic complications which could be associated with first blind umbilical entry [2]. At least 50% of the major complications occur prior to commencement of the intended surgery meaning that they are related to first blind primary umbilical port. The non-umbilical entry has been strongly advocated by a recent article entitled ‘overview of gynaecological laparoscopic surgery and non-umbilical entry site’ on “UpToDate” [1]. It recommends non-umbilical entry in previous surgery, large pelvic masses, gross obesity or underweight patients, pregnancy, very lax abdomen, and umbilical hernia. Looking at these recent guidelines, we fall in safe zone using the non-umbilical entry technique universally in all patients
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