Open Laparoscopic Access Using a Radially Dilating Trocar: Experience and Indications in 50 Consecutive Cases

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Abstract
Background: Laparoscopy can be performed using needle access for initial insufflation or open access. Patients and Methods: A technique for open laparoscopic access to the abdomen using a radially dilating cannula was used in 52 operations in 50 patients. Indications included age <2 years, severe kyphosis, and creation of an umbilical stoma. Results: There was one case of minor leakage of carbon dioxide that did not affect the procedure being performed. There were two cases of preperitoneal placement, which were recognized immediately; in both, peritoneal access was easily obtained. Conclusion: Open laparoscopic access is safely and easily performed with a radially dilating trocar. This is the preferred technique at our institution for patients who meet the criteria for open access.