Objective: To compare the three different laparoscopic entry methods: classic closed laparoscopy, left upper
quadrant entry and open laparoscopy.
Patients and methods:75 patients underwent elective laparoscopic surgery at the Obstetrics and Gynecology
department, benha university Hospital and private hospital after obtaining their informed consents .They were
randomized in to three groups:
- 25patients were assigned to classic closed laparoscopy.
- 25patients were assigned to open laparoscopy .
- 25patients were assigned to left upper quadrant entry.
The main outcome measures were statistically compared: time required for entry into abdomen and occurrence of
vascular and/or bowel injury. All patients had intraperitoneal view of the primary port site during surgical procedure.
Results: Statistical differences, in favor of the classic closed laparoscopy and lef upper quadrant entry (P < .01), were
found in duration of entry. The surgical complications in classic closed laparoscopy versus left upper quadrant entry
versus open laparoscopy were not statistically different.Conclusion: In our study, the results of this comparison of entry
methods suggest that Classic closed laparoscopy and Left upper quadrant entry a small clinical advantage over the Open
laparoscopy in patients with previous abdomino pelvic surgery, in terms of saving time. The study also suggests the
Classic closed laparoscopy and Left upper quadrant entry is easier in obese patients.
|
