A Novel Safe Laparoscopic Entry Technique In Obese Patients: An Umbilical Elevation Technique

There is a continuous search for the safest abdominal entry technique, considering the recent progressions in laparoscopic surgery. In this study, we wanted to share a novel technique that we have identified for safe laparoscopic entry in obese patients. A total of 2936 laparoscopic operations were performed in general surgery, urology, and gynecology departments of Mevlana University from 2003 to 2013. The number of patients with a body mass index (BMI) ≥30 was 764. We have identified a new technique for a safer first entry in these patients. Direct open surgery, insertion techniques in which the skin is suspended, and cases with umbilical hernia were excluded from the study. 522 (68.3%) of the cases were female, 242 (31.7%) were male, and the mean age for both genders was 51.8±12.2 years (range 27-74). The mean BMI was 34.3±3.6 (range 30-45). In 1 (0.13%) case, we had to convert to an open procedure. Wound infection developed in 7 (0.92%) of the patients. None of the patients developed intraperitoneal complication during insertion. Being safe, efficient, fast applicable, and easily learned, this new technique can be safely preferred in obese patients. © 2016, E-Century Publishing Corporation. All rights reserved.