Comparison of Open (Hasson's) Technique and Closed Entry Technique for Creation of Pneumoperitoneum in Laparoscopic Cholecystectomy
Keywords:
Laparoscopic Cholecystectomy, Pneumoperitoneum, Hasson’s technique, Veress needleAbstract
Background Laparoscopic cholecystectomy has become the gold standard for treating benign gallbladder disease, where the creation of a pneumoperitoneum—an insufflation of the abdominal cavity with gas—is a critical prerequisite. The main objective of the present study was to compare the safety and efficacy of the Open (Hasson's) method and Closed (Veress Needle) method for creating a pneumoperitoneum in laparoscopic cholecystectomy and to determine safe practices for pneumoperitoneum creation with minimal complications and higher efficacy.
Methods This prospective, randomized clinical study was conducted on 50 patients divided into 2 groups having 25 patients each at Government Medical College, Rajindra Hospital, Patiala, Punjab (India) from May 2019 to December 2020, following ethical committee approval. Data was gathered by recording the time from abdominal incision to pneumoperitoneum creation and to close the wounds. Incidence of complications were noted during the procedure and during a three-month postoperative follow-up.
Results More time was taken to achieve pneumoperitoneum and to close the port site wounds in case of Closed method of pneumoperitoneum creation, however there was no significant difference in intra-operative or post-operative complications between the two groups.
Conclusion This study indicates that both the open (Hasson’s) and closed (Veress needle) techniques are effective and safe for pneumoperitoneum creation in laparoscopic cholecystectomy, with the open technique offering a slight advantage in terms of reduced procedure time and minimal complications. Further large-scale studies may be needed to confirm these findings and provide additional insights into technique optimization.
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