Trial reportJSLS : Journal of the Society of Laparoendoscopic Surgeons
Bladeless direct optical trocar insertion in laparoscopic procedures on the obese patient.
Trial report in JSLS : Journal of the Society of Laparoendoscopic Surgeons. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Primary entry trocar design and entry-related complications at laparoscopy in obese patients: meta-analysis.BJS open · 2023Pooled it
- Laparoscopic entry techniques.The Cochrane database of systematic reviews · 2019Pooled it
- Randomized control trial on effectiveness and safety of direct trocar versus Veress needle entry techniques in obese women during diagnostic laparoscopy.Archives of gynecology and obstetrics · 2021Trial
- The Four-Clamp Technique for primary laparoscopic access in morbidly obese patients: a retrospective cohort study.Facts, views & vision in ObGyn · 2026Article
- Laparoscopic entry techniques: Which should you prefer?International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2023Review
- Postoperative transverse colon necrosis due to mesenteric injury during laparoscopic surgery for endometrial carcinoma.Journal of surgical case reports · 2023Article
- Utilizing the chest tube insertion site as the site of initial trocar insertion with an optical-access trocar in video-assisted thoracoscopic surgery for spontaneous pneumothorax.Journal of thoracic disease · 2022Article
- Evidence-based surgery for laparoscopic appendectomy: A stepwise systematic review.Surgery open science · 2021Review
- The use of optical trocars in abdominal entry among patients with obesity - A case series.Annals of medicine and surgery (2012) · 2021Article
- Safer trocar insertion for closed laparoscopic access: ex vivo assessment of an improved Veress needle.Surgical endoscopy · 2016Article
- Direct Vision Entry with Integrated Insufflation.JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
- Optimal Initial Trocar Placement for Morbidly Obese Patients.JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
- Fast, Easy, and Safe Establishment of Pneumoperitoneum in Laparoscopic Surgery: The Fingertip Technique.JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
- Operative Gynecological Laparoscopy Under Conscious Sedation.JSLS : Journal of the Society of Laparoendoscopic SurgeonsObservational
- Abdominal access in laparoscopic surgery of obese patients: a novel abdominal access technique.Annals of Saudi medicineArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecently, we have shown advantages of a direct optical entry (DOE) using a bladeless trocar in comparison with the open Hasson technique (OHT) in older reproductive-age women with previous operations, as well as in comparison with Veress needle entry in reproductive-age and postmenopausal women.
objectivesA prospective multicenter randomized study to determine whether the DOE is feasible for establishing safe and rapid entry into the abdomen in comparison with those of the OHT in reproductive-age obese women.
methodsTwo types of surgical techniques were blindly applied in 224 obese reproductive-age women with benign neoplastic diseases of ovary and uterus. Namely, laparoscopic entry into the abdomen in 108 patients was performed by DOE and in 116 women by OHT. Following parameters (entry time in seconds needed to establish the intra-abdominal vision after pneumoperitoneum, blood loss, occurrence of vascular and/or bowel injuries) were compared during surgery as main outcomes.
resultsMain baseline characteristics of patients, including age (36.1 ± 4.5 vs 35.7 ± 5.8), body mass index (34.9 ± 5.1 vs 35.1 ± 4.9 kg/m(2)), and parity (2.1 ± 0.4 vs 1.9 ± 0.9), were not significantly different between the DOE and OHT groups (P > .05). While intraoperative parameters such as the entry time (71.9 ± 3.7 vs 215.1 ± 6.2 seconds) and blood loss value (9.7 ± 6.1 vs 12.2 ± 2.9 mL) were significantly reduced in the DOE group in comparison with those of OHT group (respectively, P < .0001 and < .01), there were also trends to slight decrease of the occurrence of the minor injuries, manifested as omental small vessels rupture (0 of 108 vs 4 of 116) and punctures and pinches of jejunal serosa (0 of 108 vs 3 of 116) in patients of the DOE group in comparison with those of OHT group (respectively, P = .0515 and = .0925).
conclusionsDOE reduced entry time and blood loss with trends to slightly decrease of the occurrence of the minor vascular and bowel injuries, thus enabling a possible alternative to OHT in obese women; however, further larger trials need to confirm the possible additional benefits of a DOE.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.