Visceral Sliding Technique Is Useful for Detecting Abdominal Adhesion and Preventing Laparoscopic Surgical Complications

Abstract

Study Objective: Introduce a non-invasive method preoperatively to prevent bowel injury by the Veres needle and trocar during laparoscopy. Design: Case-controlled study. Setting: A hospital-based study. Patients: Five hundred and twelve patients who underwent laparoscopic surgery were prospectively enrolled. Intervention: A simple and non-invasive method to detect bowel adhesions preoperatively. Results: A total of 512 patients who underwent operative laparoscopy were prospectively enrolled for ultrasonographic visceral sliding evaluation. They were subdivided into two groups as follows: group I, 332 patients without previous abdominal surgery; group II, 180 patients with previous abdominal surgery. No bowel adhesion to the umbilicus was present in group I. In group II, only two cases with bowel adhered to the periumbilical area were found by visceral sliding technique. No patients suffered any bowel injury. Conclusion: The proposed technique is useful and highly effective in guiding the insertion of the Veres needle and trocar to prevent bowel injury in laparoscopy.