Umbilical stalk technique for establishing pneumoperitoneum.
The Veress needle technique for establishing pneumoperitoneum is widely used yet associated with slow insufflation and potentially life-threatening complications. The open or Hasson technique is relatively safer but considered cumbersome by many. We describe a mini-open technique that uses a 5-mm transumbilical incision and placement of a 5-mm blunt cannula without the trocar. We have employed this technique for 4 years in 600 patients without a midline laparotomy incision incorporating the umbilicus and have accessed the abdomen safely for laparoscopy without any complications. The time from skin incision to the start of the procedure is usually under 2 minutes. Our umbilical stalk technique provides rapid and safe access to the abdomen, eliminating the dangers of a blind sharp needle or trocar insertion and the need for a larger incision with placement of stay sutures. We recommend this simple technique for entry into the uncomplicated abdomen.
Carbonell
Alfredo M
AM
Department of General Surgery, Carolinas Medical Center, Carolinas Laparoscopic and Advanced Surgery Program, Charlotte, North Carolina 28203, USA.
Harold
Kristi L
KL
Smith
Trina I
TI
Matthews
Brent D
BD
Sing
Ron F
RF
Kercher
Kent W
KW
Heniford
B Todd
BT
D006801:Humans; D010535:Laparoscopy; D011028:Pneumoperitoneum, Artificial / Q000379:methods*; D011677:Punctures