Closed blunt-trocar 5 mm-port for primary cannulation in laparoscopic surgery: A safe technique.

Primary cannulation of the peritoneal cavity is a critical part of laparoscopic surgery. The aim of this study was to evaluate the safety and applicability of a direct blunt-port primary cannulation. The peritoneal cavity was accessed by direct trocar-port insertion at sites other than the umbilicus and avoiding abdominal scars.

Laparoscopic versus open splenectomy for massive splenomegaly: a comparative study.

Background: Despite the benefits of the laparoscopic approach to splenectomy, its application in patients with massive splenomegaly (splenic weight >or= 1000 g) remains controversial. In this study we evaluated the safety and feasibility of laparoscopic splenectomy for massive splenomegaly compared with open splenectomy.

Materials And Methods: One surgeon applied the laparoscopic approach to splenectomy to all comers with massive splenomegaly, while other surgeons carried out the surgery through a laparotomy.

Laparoscopic gastric and biliary bypass: a single-center cohort prospective study.

Purpose: Relief of gastric outlet and distal biliary obstruction may be accomplished by open surgery or by minimally invasive techniques including endoscopic and laparoscopic approaches. We examined the feasibility and safety of laparoscopic gastric and biliary bypass in all patients with malignant and benign disease requiring surgical relief of obstructive symptoms.

Materials And Methods: Patients with benign duodenal stricture or inoperable malignancy underwent therapeutic laparoscopic bypass surgery.

An "all 5-mm ports" selective approach to laparoscopic cholecystectomy, appendectomy, and anti-reflux surgery.

Laparoscopic appendectomy, cholecystectomy, or anti-reflux procedures are conventionally performed with the use of one and often two 10/12-mm ports. While needlescopic or micropuncture laparoscopic procedures reduce postoperative pain, they invariably involve the use of one 10/12-mm port and the instruments applied have their ergo-dynamic shortcomings. Between September 2002 and March 2003, we have attempted an "all 5-mm ports" approach in 49 laparoscopic procedures, which included 18 of 59 laparoscopic cholecystectomies (31%), 26 diagnostic laparoscopies for suspected appendicitis (of which we proceeded to a laparoscopic appendectomy in 17 patients), and in the last 5 of 9 laparoscopic Nissen fundoplications.