Open laparoscopy utilizing either a 5 mm or 10 mm standard intra-umbilicaltrocar

Objective To describe a technique for open entry for laparoscopic procedure s, utilizing either a standard 5- or 10 mm trocar through an 8- or 12 mm in tra-umbilical incision, respectively. Settings Two teaching hospitals. Subjects A total of 237 patients. The first 186 patients had a 10-mm trocar inserted, and the latter 51 patients a 5-mm trocar entry. Results The average time required to achieve pneumoperitoneum was 3.5 mm wi th no complications encountered. Gas leakage overall occurred in 4.2% of pa tients, though in no case was remedial fascial suturing required. There wer e two cases of wound infection (0.8%), including an infected umbilical haem otoma. All minor complications occurred in the first 20 patients undergoing surgery. Conclusion Open laparoscopy using this technique is safe, quick, and cosmet ically excellent with minimal complications and no major disadvantages. It provides an improved safety margin for vascular injury in comparison to clo sed peritoneal entry, though it is theoretically capable of causing type II visceral injuries.