title: Primary left upper quadrant (Palmer's point) access for laparoscopic radical prostatectomy.
abstract: OBJECTIVE
  Although Palmer's point approach is described for upper urinary tract laparoscopy, we use this technique routinely for robotic and standard laparoscopic radical prostatectomy and we describe our experience with this approach.
  
  
  METHODS
  Since 2004, Palmer's point Veress entry has been used to create pneumoperitoneum in 126 robotic and 21 standard laparoscopic radical prostatectomies. On the left side, a 2-mm transverse skin incision was made 3 cm below the left costal margin on the midclavicular line. Through this incision, a Veress needle was inserted to create pneumoperitoneum.
  
  
  RESULTS
  The mean patient's age and body mass index were 59.7 years (range, 37 to 73 years) and 27.92 kg/m2 (range, 22 to 39 kg/m2), respectively.Thirty-eight patients had prior abdominal operations. The mean number of punctures performed was 1.08 per case. In 93% of the subjects, Veress needle was inserted during the first attempt. The mean time to establish pneumoperitoneum was 5.63 minutes (range, 4 to 8 minutes). No major entrance injuries occurred.
  
  
  CONCLUSIONS
  Palmer's point upper quadrant Veress needle access may be a safe and effective method of establishing pneumoperitoneum in patients subjected to robotic and standard laparoscopic radical prostatectomy.
authors.affiliation: Istanbul Bilim University, Istanbul,Turkey. iltertuf@gmail.com
authors.forename: Ilter
authors.initials: I
authors.lastname: Tüfek
authors.forename: Haluk
authors.initials: H
authors.lastname: Akpınar
authors.forename: Cüneyd
authors.initials: C
authors.lastname: Sevinç
authors.forename: Ali Rıza
authors.initials: AR
authors.lastname: Kural
mesh_terms: D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods*; D011469:Prostatic Diseases / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome