title: Laparoscopic access overview: Is there a safest entry method?
abstract: BACKGROUND
  Laparoscopy is a minimally invasive technique to access the abdominal cavity, for diagnostic or therapeutic applications. Optimizing the access technique is an important step for laparoscopic procedures. The aim of this study is to assess the outcomes of different laparoscopic access techniques and to identify the safest one.
  
  
  METHODS
  Laparoscopic access questionnaire was forwarded via e-mail to the 60 centers who are partners in working group for laparoscopic and robotic surgery of the Italian Urological Society (SIU) and their American and European reference centers.
  
  
  RESULTS
  The response rate was 68.33%. The total number of procedures considered was 65.636. 61.5% of surgeons use Veress needle to create pneumoperitoneum. Blind trocar technique is the most commonly used, but has the greatest number of complications. Optical trocar technique seems to be the safest, but it's the less commonly used. The 28,2% of surgeons adopt open Hasson's technique. Total intra-operative complications rate was 3.3%. Open conversion rate was 0.33%, transfusion rate was 1.13%, and total post-operative complication rate was 2.53%.
  
  
  CONCLUSIONS
  Laparoscopic access is a safe technique with low complication rate. Most of complications can be managed conservatively or laparoscopically. The choice of access technique can affect the rate and type of complications and should be planned according to surgeon experience, safety of each technique and patient characteristics. All access types have perioperative complications. According with our study, optical trocar technique seems to be the safest.
authors.affiliation: Departamento de Urología, Universidad de Módena & Reggio Emilia, Módena, Italia. Electronic address: bianchi.giampaolo@unimore.it.
authors.forename: G
authors.initials: G
authors.lastname: Bianchi
authors.affiliation: Departamento de Urología, Universidad de Módena & Reggio Emilia, Módena, Italia.
authors.forename: E
authors.initials: E
authors.lastname: Martorana
authors.affiliation: Departamento de Urología, Universidad de Tanta, Tanta, Egipto.
authors.forename: A
authors.initials: A
authors.lastname: Ghaith
authors.affiliation: Departamento de Urología, Universidad de Módena & Reggio Emilia, Módena, Italia.
authors.forename: G M
authors.initials: GM
authors.lastname: Pirola
authors.affiliation: Departamento de Urología, Universidad de Módena & Reggio Emilia, Módena, Italia.
authors.forename: M
authors.initials: M
authors.lastname: Rani
authors.affiliation: Departamento de Urología, Universidad Tor Vergata, Roma, Italia.
authors.forename: P
authors.initials: P
authors.lastname: Bove
authors.affiliation: Departamento de Urología, Hospital San Luigi Gonzaga, Orbassano, Torino, Italia.
authors.forename: F
authors.initials: F
authors.lastname: Porpiglia
authors.affiliation: Departamento de Urología, Hospital Sant'Orsola-Malpighi, Bolonia, Italia.
authors.forename: F
authors.initials: F
authors.lastname: Manferrari
authors.affiliation: Departamento de Urología, Universidad de Módena & Reggio Emilia, Módena, Italia.
authors.forename: S
authors.initials: S
authors.lastname: Micali
mesh_terms: D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods*; D061214:Patient Safety; D011183:Postoperative Complications / Q000453:epidemiology; D010818:Practice Patterns, Physicians'; D057566:Self Report; D013520:Urologic Surgical Procedures / Q000379:methods*; D014572:Urology
keywords: Acceso; Access; Choice; Complicaciones; Complications; Elección; Laparoscopia; Laparoscopy; Safety; Seguridad