PP 24. Techniques And Complications Of Establishing Pneumoperitoneum.

---

L. Wheldon, N. Samuel, M. Hanif Shiwani

18:58 - 19:04h at Margrit Room

Categories: Gastrointestinal Surgery, Poster Session , Robotic and Minimal Invasive Surgery

Session: Poster (P2) - Gastrointestinal Surgery / Minimal Invasive

---

Background
Several techniques are described to establish pneumoperitoneum. Pneumopertoneum was traditionally created using Verres needle often favoured by gynaecologists, until Hasson described his open entry technique favoured by general surgeons. Also widely used is optical port entry. Complications of laparoscopic surgery are rare but many are associated with establishing pneumoperitoneum. We aim to assess current practice of surgeons and evaluate their life times experience including complications.

Material and Methods
A single centre observational study was designed. Data was collected anonymously using a validated questionnaire capturing, technique, site, experience, details of complications encountered and severity using Calvin Dindo Classification. All eligible surgeons (general surgeons, gynaecologists, urologists) performing laparoscopic surgery were invited to participate. The data was then analysed using SPSS with further subgroup analysis by speciality and technique.

Result
n=19 surgeons (General Surgical n=12 (63%), Gynaecology n=7 (37%)). General surgeons preferred the open technique (n=11) and gynaecologists preferred Verres needle (n=7). The site of entry varied and no site was associated with increased complications. 6 (31.6%) surgeons have experienced complications 4 Gynaecologists all using Verres needle and 2 General surgeons who used open technique. The most common injury was to the colon (n=4/6). 5 of the 4 complications were grade III, 1 grade IV. There was no associated mortality.

Conclusion
This study is limited due to the small numbers but might suggests that Verres needle entry is associated with more complications than open technique. Further study is required to clarify this.