Comparison of Transperitoneal Laparoscopic Access Techniques: Optiview Visualizing Trocar and Veress Needle

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Abstract
Purpose: We retrospectively compared the safety, efficacy, and relative indications of the Optiview visualizing trocar and the Veress needle for obtaining transperitoneal laparoscopic access. Patients and Methods: Of 100 consecutive transperitoneal laparoscopic procedures performed by a single surgeon, the Veress needle was used initially in 96 patients. The Optiview was used on 26 occasions: in 4 patients as the initial access attempt, and in 22 patients after the Veress needle had failed. Patient characteristics (age, body mass index [BMI], American Society of Anesthesiologists [ASA] score, and history of abdominal surgery), success rates, and complications were compared. Results: Access was obtained successfully with the Optiview in 25 of 26 cases (96%), whereas the Veress needle was successful in 72 of 96 (75%; P = 0.02). The Hasson cannula was used successfully after two of the Veress needle failures and the single Optiview failure. Age, BMI, ASA score, and history of abdominal surgery were ...