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Umbilical stalk elevation technique for safer Veress needle insertion in obese patients: a case–control study     
Yazarlar
İsa Aykut Özdemir
Türkiye
Kemal Güngördük
Türkiye
Prof. Dr. Kahraman ÜLKER Prof. Dr. Kahraman ÜLKER
İstanbul Rumeli Üniversitesi, Türkiye
Levent Yaşar
Türkiye
İbrahim Egemen Ertaş
Türkiye
Mehmet Gökçü
Türkiye
Ulaş Solmaz
Türkiye
Muzaffer Sancı
Türkiye
Özet
The purpose of this retrospective study was to compare our umbilical stalk elevation (USE) technique with the classic Veress needle (VN) technique in obese patients. The USE technique was performed on 40 patients. One control per case was randomly selected from among those undergoing the classic VN technique using a random number table. In USE technique, a 12 mm skin incision was created at the superior crease of the umbilical fold, and the underlying subcutaneous adipose tissue was bluntly dissected using the tip of a fine clamp until the umbilical stalk was isolated at the inferior and central part of the incision. Next, the umbilical stalk was covered and held by a towel clip, and the abdominal wall was elevated by upward traction. The VN was then inserted nearly perpendicular to the incision and turned toward the pelvis immediately after resistance to the needle had been lost. A post-hoc power analysis was performed. The number of attempts was significantly lower in the USE laparoscopy group than in the classic laparoscopy group (1.2 ± 0.4 vs. 2.1 ± 0.7, respectively; P<0.001). The USE technique group had a slightly shorter abdominal entry time than did the classic technique group (328.52 ± 63.71 vs. 434.95 ± 124.10s; P<0.001). Six (7.5%) failed insufflations occurred in our study (5 patients in the classic group vs. 1 patient in the USE group (P=0.10). Our novel USE technique can be an effective means of establishing pneumoperitoneum in obese patients undergoing gynecologic laparoscopic procedures.
Anahtar Kelimeler
Gynecologic laparoscopy | Umbilical stalk elevation technique | Pneumoperitoneum | Veress needle | Obese patient
Makale Türü Özgün Makale
Makale Alt Türü SSCI, AHCI, SCI, SCI-Exp dergilerinde yayımlanan tam makale
Dergi Adı EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY
Dergi ISSN 0301-2115
Dergi Tarandığı Indeksler SCI
Makale Dili İngilizce
Basım Tarihi 09-2014
Cilt No 180
Sayfalar 168 / 171
Doi Numarası 10.1016/j.ejogrb.2014.06.012
Makale Linki http://dx.doi.org/10.1016/j.ejogrb.2014.06.012