Comparison Effect of Direct Trocar and Veress Needle Entry Techniques on Gut Functions after Laparoscopic Procedures: Randomized Clinical Trial

Abstract

OBJECTIVE: The aim of this study was to compare the effect of two different laparoscopic entry methods on postoperative gastrointestinal functions.STUDY DESIGN: A total of 108 women who underwent gynecological operation via laparoscopic approach with different indications were randomly assigned to 2 groups: In Group 1 pneumoperiteneumwas achieved by direct trocar entry (n=72), while in group 2, Veress needle was used.RESULTS: Correlation analyses showed a significant association between the technique for abdominalentry and postoperative hemoglobin and hematocrit concentrations, time to maximal intraabdominalpressure and the body mass index. Comparison of groups with different laparoscopic entry techniquesshowed a significant difference between groups in terms of postoperative hemoglobin and hematocritconcentrations, time to obtain maximal intraabdominal pressure and time to first flatulence (p<0.05). Nointra or postoperative complications was observed.CONCLUSION: Direct or Veress needle entry methods were both safe to create pneumoperitoneumwith similar postoperative gastrointestinal functions except for earlier first flatulence in Veress needlegroup while direct trocar entry was found to be associated with favorable postoperative blood count andshorter duration to obtain enough intraperitoneal pressure.