A Comparative Study of (Hassons) / Open Method Technique v/s Veress Needle / Closed Method of Creating Pneumoperitoneum in Laparoscopic Surgeries

INTRODUCTION: Laparoscopy is the art of examining the abdominal cavity& its contents. Laparoscopic surgery carries its own risks and complications, Almost half of these complications occur at the time of port placement& creating the pneumoperitonium. Peritoneal access and creation of pneumoperitoneum are key initial steps of laparoscopic surgery and divided into open or closed entry technique. Closed techniques include Veress Needle technique and the direct trocar insertion technique. The open (Hasson) technique consists of an initial incision into the peritoneum allowing direct visualization of the insertion of a blunt trocar. AIMS AND OBJECTIVE: study the comparison and efficacy between closed (veress needle) and open method (Hasson’s) of intraperitoneal access to create pneumoperitoneum in laparoscopic surgeries. Methods: All laparoscopic procedure undergoing at HAMIDIA HOSPITAL bhopal from July 2018 to July 2019. This was Prospective study and total 160 cases of Laparoscopic surgery were taken in 1-year period. Student t test had been used to find the significance of study parameters on continuous scale between two groups. All data were entered and calculated in Microsoft Excel sheet. Results: The Mean operative time for access in veress needle group was 5.12 mins as compare to open method where it was 3.94 mins. Port site Gas leakage was slightly more in open method. Major vascular and visceral injuries did not occur in any of the group Overall, There were slightly more Minor complications: Omental injury, extra peritoneal insufflations, loss of space and entry in wrong plane associated with closed method than open method. Conclusions: Both closed& open methods are safe and the open technique had a time advantage over the closed method. There were no major complications occurred in any group and minor complications occur in slightly higher in close method. Overall, open technique is as good as closed technique and good alternative to closed technique.