title: [Minilaparoscopy below the left costal border with radially expanding STEP-Trocar-System in patients with previous pelvic surgery--results of a pilot study].
abstract: As a part of a prospective study of 20 patients with previous pelvic surgery, the efficacy of using a 2/3 mm dilatable STEP device (InnerDyne, Inc., Sunnyvale, USA) for the first insertion in the area below the left costal border was tested, using 2 or 3.3 mm minilaparoscopes (Storz). Despite the high incidence of periumbilical omental and bowel adhesions (55%), no complications were observed in any of the 20 patients with previous pelvic surgery. Herewith could be confirmed that the use of a minilaparoscope in the area below the left costal border represents in high risk patients a safe and minimally invasive method for preventing or reducing the number of trocar-related injuries during first trocar insertion. In combination with the use of 2/3 mm disposable STEP-trocars if clinically required an atraumatic dilation and safe insertion of reusable 5 mm, 10 mm or 12 mm trocars is enabled.
authors.affiliation: Klinik für Frauenheilkunde und Geburtshilfe der Ernst-Moritz-Arndt-Universität Greifswald. bojahrb@rz.uni-greifswald.de
authors.forename: B
authors.initials: B
authors.lastname: Bojahr
authors.forename: G
authors.initials: G
authors.lastname: Tchartchian
authors.forename: B
authors.initials: B
authors.lastname: Hinken
authors.forename: D
authors.initials: D
authors.lastname: Arndt
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007813:Laparotomy; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010865:Pilot Projects; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012086:Reoperation; D012272:Ribs; D013525:Surgical Instruments