title: Safe and easy access technique for the first trocar in laparoscopic surgery.
abstract: BACKGROUND
  Access-related injuries are still an important consideration and may increase morbidity and mortality. This study aimed to present in detail a safe and easy technique for open insertion of the first trocar.
  
  
  METHODS
  This technique has been used routinely in the vast majority of laparoscopic procedures at first author's department since 1998. The data were collected prospectively and analyzed retrospectively for the 11-year period of January 2005 through December 2015. The primary site of access is the umbilicus, but this technique can be used for all insertion points.
  
  
  RESULTS
  A total of 2579 laparoscopic surgical interventions were performed. The abdominal access was established in 2252 patients in open and in 321 cases with blind puncture using a Veress needle. There were three cases (0.9 %) of accidental injuries with blind puncture and two cases (0.09 %) with open technique. Injuries sustained with open technique injuries were less severe and immediately discernable. None of the patients were converted to open technique.
  
  
  CONCLUSIONS
  The method can be used easily and rapidly, even in obese patients. It is safer than blind puncture and reduces costs.
authors.affiliation: Department of Surgery, Medical University of Graz, Auenbruggerplatz 29, 8036, Graz, Austria.
authors.forename: Selman
authors.initials: S
authors.lastname: Uranues
authors.affiliation: Department of General Surgery, Faculty of Medicine, Sakarya University, Adnan Menderes Caddesi, Saglik Sokak No: 193, 54100, Sakarya, Turkey. veliorhan@hotmail.com.
authors.forename: Orhan Veli
authors.initials: OV
authors.lastname: Ozkan
authors.affiliation: Department of Gynecology and Obstetrics, Medical University of Graz, 8036, Graz, Austria.
authors.forename: Gordana
authors.initials: G
authors.lastname: Tomasch
mesh_terms: D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D000072836:Surgical Wound; D014472:Umbilicus
keywords: Access complications; First trocar; Laparoscopic entry technique; Open access; Open trocar insertion