Abstract
Background: Laparoscopic surgery or "minimally invasive" surgery is a type of specialist surgery. The most crucial, demanding, and risky part of the laparoscopy is the creation of pneumoperitoneum. The two most prevalent methods for creating a pneumoperitoneum are the closed and open approaches. Despite the fact that there is no universal consensus on the best approach to gain access to the peritoneal cavity in order to create a pneumoperitoneum. The aim of present study was to compare the operative time and post-operative outcome associated with closed technique and open classic technique.
 Methods: This randomized controlled trial was carried out by recruiting patients presented in surgery department of Ziauddin Hospital North campus. The samples were divided into two equal groups A and B. Group A was operated for Laparascopic abdominal surgery by open technique while group B operated through closed technique. Effectiveness of procedures was measured by number of complications occurred during and after surgery. Chi-square test and independent T-test were applied for association. P-value of < 0.05 was considered as significant.
 Results: Mean age was found to be 45.5±16 years and mean weight was 68±10.5 kilograms. Mean time of operations was 84.5±18.5 minutes. 60 (69.8%) of patients included underwent the laparoscopic cholecystectomy while 15 (17.4%) patients had laparoscopic appendectomy. 13/86: 15.1% of patients had the minor complication including 12/43: 27.9% in group B and 1/43: 2.3% in group A. The comparative analysis between the two groups in terms of effectiveness of either method compared by means of development of the complications was found to be highly significant with p value 0.002.
 Conclusion: The open approach to laparoscopic entrance has been linked to fewer surgical problems than the closed approach.
Highlights
Laparoscopic surgery, sometimes known as "minimally invasive" surgery, is a type of specialist surgery
All 126 study subjects were separated into two equal groups: group A, consisting of 43 patients, was operated on using the open (Hasson technique), whereas group B, consisting of 43 patients, was operated on using the closed (Palmers point) technique
As our study had more number of female patients so majority of them had history of previous caesarean section (17: 19.8%) followed by the patients having history of trans-abdominal hysterectomy and bilateral salpingo-oophorectomy (3: 3.5%) and remaining 58: 67.4% had no history of previous abdominal surgery. 60 (69.8%) of patients included underwent the laparoscopic cholecystectomy while 15 (17.4%) patients had laparoscopic appendectomy Fig. 1
Summary
Laparoscopic surgery, sometimes known as "minimally invasive" surgery, is a type of specialist surgery. This method was historically widely used in gynecologic and gallbladder surgeries [1]. Laparoscopic surgery was a watershed moment in surgery, ushering in a shift from open abdominal surgery to the minimally invasive surgical revolution [2]. The two most prevalent methods for creating a pneumoperitoneum are the closed (Palmer’s point) and open (Classic/Hasson) approaches [6]. The two most prevalent methods for creating a pneumoperitoneum are the closed and open approaches. The aim of present study was to compare the operative time and post-operative outcome associated with closed technique and open classic technique. Group A was operated for Laparascopic abdominal surgery by open technique
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