| [ Summary ] |
Trocar placement, an important procedure in preparing for laparoscopic surgery, is occasionally associated with serious complications. Pitfalls of trocar insertion and needle puncture, as well as technical points aimed at avoiding complications, are described. There are two methods of trocar insertion, the puncture method and the open method. Although the puncture method is easy and less invasive, it carries the risk of bowel or vascular injury because the Verres needle and the first trocar are inserted blindly. On the other hand, the open method is rather complicated and more invasive, but carries minimal risk of serious bowel or vascular injury. As intra-abdominal adhesion increases the risk of puncture injury, the open method should be applied when intra-abdominal adhesion is anticipated. When a puncture injury has occurred, prompt conversion to open surgery is recommended to avoid serious complications. |