COMPARISON BETWEEN CLOSED AND OPEN METHODS FOR CREATING PNEUMOPERITONEUM IN LAPAROSCOPIC SURGERY

Abstract

Introduction:

 Laparoscopic surgery has evolved significantly since its inception, with pneumoperitoneum creation being a critical step. The study compares the safety and efficiency of the closed (Veress needle) and open (Hasson) methods for creating pneumoperitoneum.

Methods:

This retrospective study included 50 patients undergoing laparoscopic surgery, divided into two groups: closed method (n=25) and open method (n=25). The study analyzed access time, postoperative pain, total operating time, wound closure time, and complications. Statistical analyses included T-tests, Mann-Whitney U tests, and Chi-square tests to compare continuous and categorical variables.

Results:

The open method demonstrated a significantly shorter mean access time of 6.8 minutes compared to 8.9 minutes for the closed method (p<0.001). The closed method had a 12% failure rate, while the open method had no instances of gas leaks or technique failure. No significant differences were found between the two methods regarding total operating time, wound closure time, or hospital stay duration. Importantly, neither method resulted in visceral or vascular injuries.

Conclusion:

The open method is faster in establishing pneumoperitoneum and may be safer, particularly for less experienced surgeons. Both methods are generally safe and effective, but further studies with larger sample sizes are needed to confirm these findings and develop definitive guidelines.