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Journals / Endoüroloji Bülteni / 2026 / Cilt: 18 Sayı: 1

Comparison of A Novel Open Fingertip Technique for Laparoscopic Entry with the Veress Needle

Laparoskopik Girişte Veress İğne Tekniği İle Açık Fingertip Tekniğinin Karşılaştırılması

Erdinç Dinçer(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL KARTAL DR. LÜTFİ KIRDAR ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ÜROLOJİ ANABİLİM DALI)0000-0002-0644-8282
Orkunt Özkaptan(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL KARTAL DR. LÜTFİ KIRDAR ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ÜROLOJİ ANABİLİM DALI)0000-0003-3659-1319
Alkan Çubuk(Bursa Medicana Hastanesi)0000-0001-9322-9717
Cengiz Çanakçı(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL KARTAL DR. LÜTFİ KIRDAR ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ÜROLOJİ ANABİLİM DALI)0000-0002-2654-1986
Utku Can(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL KARTAL DR. LÜTFİ KIRDAR ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ÜROLOJİ ANABİLİM DALI)0000-0002-9805-3930
Ahmet Şahan(Bursa Medicana Hastanesi)0000-0001-8079-5875
Pages
39–48
Publication Date
2026-01-29
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

The overall complication rates were 4 (8.8%) in the Veress needle group and 3 (6.6%) in the fingertip group (p = 0.693).

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: To compare our novel abdominal entry technique (i.e., the fingertip technique) with the Veress needle technique in laparoscopic urological surgery, in terms of feasibility and complications.
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Key Findings & Data:Material And Methods: A total of 90 patients who underwent laparoscopic transperitoneal surgery were assigned to either the Fingertip technique group (n = 45) or the Veress needle technique group (n = 45).
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Conclusion & Impact:The overall complication rates were 4 (8.8%) in the Veress needle group and 3 (6.6%) in the fingertip group (p = 0.693).
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:komplikasyon · fingertip tekniği · gaz kaçağı

Abstract

Objective: To compare our novel abdominal entry technique (i.e., the fingertip technique) with the Veress needle technique in laparoscopic urological surgery, in terms of feasibility and complications. Material And Methods: A total of 90 patients who underwent laparoscopic transperitoneal surgery were assigned to either the Fingertip technique group (n = 45) or the Veress needle technique group (n = 45). The duration of time for initial entry, the occurrence of gas leakage, the number of attempts for successful entry into the abdomen, and the complications were evaluated. Results: The two groups had comparable demographic characteristics. The laparoscopic entry time was shorter in the fingertip group than it was in the Veress needle group (175.7 ± 64.9 versus 103.8 ± 26.7 s; p < 0.001). Pneumoperitoneum was established at the first attempt in 35 (77.7%) of the Veress needle patients and in 45 (100%) patients in the fingertip method group. The overall complication rates were 4 (8.8%) in the Veress needle group and 3 (6.6%) in the fingertip group (p = 0.693). In the Veress needle group, minor complications included liver injury in one patient, intestinal injury in one patient, subcutaneous emphysema in one patient and omental injury or insufflation in one patient. In contrast, in the fingertip group, subcutaneous bleeding occurred in three patients. Conclusion: The fingertip technique may be considered as a feasible option for laparoscopic entry with its lower complications rates and shorter applying time compared to the Veress needle technique.

Özet

Amaç: Laparoskopik ürolojik cerrahide yeni abdominal giriş tekniğimizi (fingertip tekniği) Veress iğnesi tekniği ile uygulanabilirlik ve komplikasyon açısından karşılaştırmayı planladık. Gereç ve Yöntemler: Laparoskopik transperitoneal cerrahi planlanan 90 hasta, veress iğne tekniği (n = 45) ve fingertip tekniği (n = 45) olmak üzere üzere iki gruba ayrıldı. Batına giriş süresi, gaz kaçağı oluşumu, batına başarılı giriş deneme sayısı ve komplikasyonlar değerlendirildi. Bulgular: İki grup benzer demografik özelliklere sahipti. Laparoskopik giriş süresi fingertip grubunda Veress iğnesi grubuna göre daha kısaydı (175,7 ± 64,9’ a karşılık 103,8 ± 26,7 sn; p < 0,001). Veress iğnesi grubundaki hastaların 35’ inde (%77,7), fingertip yöntemi grubunda ise 45 (%100) hastada ilk denemede pnömoperiton oluştu. Genel komplikasyon oranları Veress iğnesi grubunda 4 (%8,8) ve parmak ucu grubunda 3 (%6,6) idi (p = 0,693). Veress iğnesi grubunda minör komplikasyonlar; bir hastada karaciğer hasarı, bir hastada bağırsak yaralanması, bir hastada cilt altı amfizemi ve bir hastada omentum yaralanması veya insuflasyonu olarak raporlandı. Fingertip grubunda ise 3 hastada cilt altı kanama meydana geldi. Sonuç: Fingertip tekniği, Veress iğnesi tekniğine göre daha düşük komplikasyon oranları ve daha kısa uygulama süresi ile laparoskopik giriş için uygun bir seçenek olarak değerlendirilebilir.

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Cite This Article

Dinçer, E., Özkaptan, O., Çubuk, A., Çanakçı, C., Can, U., Şahan, A. (2026). Comparison of A Novel Open Fingertip Technique for Laparoscopic Entry with the Veress Needle. Endoüroloji Bülteni, Cilt: 18 Sayı: 1, 39–48. https://doi.org/10.54233/endourolbull-1813215

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References (30)

  1. Hasson HM. A modified instrument and method for laparoscopy. Am J Obstet Gynecol. 1971;110:886-7. https://doi.org/10.1016/0002-9378(71)90593-x
  2. Fuller J, Ashar BS, Carey-Corrado J. Trocar-associated injuries and fatalities: an analysis of 1399 reports to the FDA. J Minim Invasive Gynecol. 2005;12:302-7. https://doi.org/10.1016/j.jmig.2005.05.008
  3. Ahmad G, Baker J, Finnerty J, Phillips K, Watson A. Laparoscopic entry techniques. Cochrane Database Syst Rev. 2019;1:CD006583. https://doi.org/10.1002/14651858.CD006583.pub5
  4. Simforoosh N, Basiri A, Ziaee SA, Tabibi A, Nouralizadeh A et al. Major vascular injury in laparoscopic urology. JSLS. 2014;18:e2014.00283. https://doi.org/10.4293/JSLS.2014.00283
  5. Varghese A, Peijnenburg E, Stone RL, Wethington SL, Levinson KL et al. Laparoscopic surgical access in morbidly obese women undergoing endometrial cancer surgery: Repurposing the left upper quadrant approach. Eur J Obstet Gynecol Reprod Biol. 2020;244:56-9. https://doi.org/10.1016/j.ejogrb.2019.11.007
  6. Uranues S, Ozkan OV, Tomasch G. Safe and easy access technique for the first trocar in laparoscopic surgery. Langenbecks Arch Surg. 2016;401:909-12. https://doi.org/10.1007/s00423-016-1474-4
  7. Tinelli A, Malvasi A, Mynbaev OA, Tsin DA, Davila F et al. Bladeless direct optical trocar insertion in laparoscopic procedures on the obese patient. JSLS. 2013;17:521-8. https://doi.org/10.4293/108680813X13693422519398
  8. S Sakamoto A, Kikuchi I, Shimanuki H, Tejima K, Saito J et al. Initial closed trocar entry for laparoscopic surgery: Technique, umbilical cosmesis, and patient satisfaction. Gynecol Minim Invasive Ther. 2017;6:167-72. https://doi.org/10.1016/j.gmit.2017.04.001
  9. Evsen MS, Icen MS, Findik FM, Tunc SY, Ağaçayak E et al. A new technique in laparoscopic abdominal access (Evsen Method, Modified Veress Technique). Ginekol Pol. 2018; 89:481-4. https://doi.org/10.5603/GP.a2018.0082
  10. Cassata G, Palumbo V, Cicero L, De Luca A, Damiano G et al. OneShot-M: A New Device for Close Laparoscopy Pneumoperitoneum. Surg Innov. 2018;25:570-7. https://doi.org/10.1177/1553350618799542
  11. Antevil JL, Bhoyrul S, Brunson ME, Vierra MA, Swadia ND. Safe and rapid laparoscopic access--a new approach. World J Surg. 2005;29:800-3. https://doi.org/10.1007/s00268-005-7730-3
  12. Adshead J, Hanbury DH, Boustead GB, McNicholas TA, Boomers O, et al. Novel method for open-access laparoscopic port insertion using the killian nasal speculum: the lister technique. J Endourol. 2008;22:317-9. https://doi.org/10.1089/end.2007.0142.
  13. Ciravolo G, Donarini P, Rampinelli F, Visenzi C, Odicino F. Laparoscopic Access with Optical Gasless Trocar: A Single-center Experience of 7431 Procedures. J Minim Invasive Gynecol. 2020;27:535-40. https://doi.org/10.1016/j.jmig.2019.03.025
  14. Habibi M, Seyit H, Kones O, Kartal B, Alis H. Direct Trocar Insertion with Elevation of the Rectus Sheath in Bariatric Surgery: A Novel Technique. Pol Przegl Chir. 2017;89:23-5. https://doi.org/10.5604/01.3001.0010.6740
  15. Carlson WH, Tully G, Rajguru A, Burnett DR, Rendon RA. Cameraless peritoneal entry in abdominal laparoscopy. JSLS. 2012;16:559-63. https://doi.org/10.4293/108680812X13462882737014
  16. Carlson JW, DeCou JM. UREKA: umbilical ring easy kannula access. JSLS. 2011;15:62-4. https://doi.org/10.4293/108680811X13022985131255
  17. Silay MS, Tepeler A, Sancaktutar AA, Kilincaslan H, Altay B et al. The all-seeing needle instead of the Veress needle in pediatric urologic laparoscopy. J Endourol. 2013;27:1376-80. https://doi.org/10.1089/end.2013.0054
  18. Sahan A, Orkunt O, Alkan C, Kosemen M, Akca O. A Novel Open Abdominal Entry Method: Fingertip Technique. Videourology. 2020;0:null. https://doi.org/10.1089/vid.2020.0048
  19. Shayani-Nasab H, Amir-Zargar MA, Mousavi-Bahar SH, Kashkouli AI, Ghorban-Poor M et al. Complications of entry using Direct Trocar and/or Veress Needle compared with modified open approach entry in laparoscopy: six-year experience. Urol J. 2013;10:861-5.
  20. Şahan A. The Fingertip technique (A novel laparoscopic abdominal entry method). [Internet]. https://www.youtube.com/watch?v=DEuw_uiFYBY&t=599s. Published 2020. Accessed.
  21. Bonjer HJ, Hazebroek EJ, Kazemier G, Giuffrida MC, Meijer WS et al. Open versus closed establishment of pneumoperitoneum in laparoscopic surgery. Br J Surg. 1997;84:599-602. https://doi.org/10.1046/j.1365-2168.1997.d01-1355.x
  22. Teoh B, Sen R, Abbott J. An evaluation of four tests used to ascertain Veres needle placement at closed laparoscopy. J Minim Invasive Gynecol. 2005;12:153-8. https://doi.org/10.1016/j.jmig.2005.01.011
  23. Pratap A, Oleynikov D, Kothari V. Real time ultrasound guided insertion of Veress needle in obese patients. Ann R Coll Surg Engl. 2018;100:158-9. https://doi.org/10.1308/rcsann.2017.0135
  24. Kaistha S, Kumar A, Gangavatiker R, Br S, Sisodiya N. Laparoscopic Access: Direct Trocar Insertion Versus Open Technique. J Laparoendosc Adv Surg Tech A. 2019;29:489-94. https://doi.org/10.1089/lap.2018.0408
  25. Mohammadi M, Shakiba B, Shirani M. Comparison of two methods of laparoscopic trocar insertion (Hasson and Visiport) in terms of speed and complication in urologic surgery. Biomedicine (Taipei). 2018;8:22. https://doi.org/10.1051/bmdcn/2018080422
  26. Lal P, Vindal A, Sharma R, Chander J, Ramteke VK. Safety of open technique for first-trocar placement in laparoscopic surgery: a series of 6,000 cases. Surg Endosc. 2012;26:182-8. https://doi.org/10.1007/s00464-011-1852-5
  27. Monnet E. Laparoscopic entry techniques: What is the controversy? Vet Surg. 2019;48(S1):O6-O14. https://doi.org/10.1111/vsu.13220
  28. Ertugrul I, Kayaalp C, Yagci MA, Sumer F, Karagul S et al. Comparison of Direct Trocar Entry and Veress Needle Entry in Laparoscopic Bariatric Surgery: Randomized Controlled Trial. J Laparoendosc Adv Surg Tech A. 2015;25:875-9. https://doi.org/10.1089/lap.2015.0317
  29. Mikhail E, Tamhane N, Sarkar P, Sappenfield E, Tanner JP et al. Laparoscopic Entry Technique Using a Veress Needle Insertion with and without Concomitant CO2 Insufflation: A Randomized Controlled Trial. J Minim Invasive Gynecol. 2019;26:1383-8. https://doi.org/10.1016/j.jmig.2019.02.011
  30. Pantoja Garrido M, Frías Sánchez Z, Zapardiel Gutiérrez I, Torrejón R, Jiménez Sánchez C et al. Direct trocar insertion without previous pneumoperitoneum versus insertion after insufflation with Veress needle in laparoscopic gynecological surgery: a prospective cohort study. J Obstet Gynaecol. 2019; 39:1000-5. https://doi.org/10.1080/01443615.2019.1590804