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Our Experience of Open Technique of Creating Pneumoperitoneum through Umbilical Cicatrix from a Remote Health Facility

technique namely reduced incidences of failed trocar entry environment of open access technique under vision gives
and extraperitoneal insufflations. 2 additional confidence to a biginner.
Traditional Hasson’s technique, although safe especially The open technique of creating pneumoperitoneum
in case of reoperative abdomen with adhesions, is time through the umbilical cicatrix is a safe and rapid technique.
3
consuming. Secondly it is associated with frequent leaks.
In contrast, open technique by direct trocar entry is faster REFERENCES
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As mentioned previously, we had two incidences of
extra-peritoneal insufflations. This was due to port insertion ABOUT THE AUTHORS
at a place away from the junction of the umbilicus and the
Aswini Kumar Misro (Corresponding Author)
linea alba where the peritoneum tends to remain as a separate
layer. Hence, the port enters into the extraperitoneal space Assistant Professor, Department of Surgery, Lumbini Medical
leading to extraperitoneal insufflation. Choosing the correct College and Research Centre, Pravas, Tansen, Palpa, Nepal, Phone:
097775691344, e-mail: draswini@gmail.com
site of insertion avoids this problem.
Especially for the beginners starting laparoscopy, the Prakash Sapkota
closed technique of creating pneumoperitoneum requires
Lecturer, Department of Surgery, Lumbini Medical College and
some amount of adaptation of motor skills to learn the
Research Centre, Pravas, Tansen, Palpa, Nepal
technique of blind first port insertion where as in open
technique the first port is always under visual and tactile Radhika Misro
guidance. Secondly, the air entry before the port insertion
Medical Officer, Department of Surgery, Lumbini Medical College
makes sufficient space for safe port entry. The controlled and Research Centre, Pravas, Tansen, Palpa, Nepal

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