Guideline No. 412: Laparoscopic Entry for Gynaecological Surgery.

Abstract

OBJECTIVE:

To evaluate the benefits and risks of laparoscopic surgery and provide clinical direction on entry techniques, technologies, and their associated complications in gynaecological surgery.

TARGET POPULATION:

All patients, including pregnant women and women with obesity, undergoing laparoscopic surgery for various gynaecological indications.

OPTIONS:

The laparoscopic entry techniques and technologies reviewed in formulating this guideline included the closed (Veress needle-pneumoperitoneum-trocar) technique, direct trocar insertion, open (Hasson) technique, visual entry systems, and disposable shielded and radially expanding trocars.

OUTCOMES:

Implementation of this guideline should optimize decision-making in the selection of entry technique for laparoscopic surgery.

EVIDENCE:

We searched English-language articles from September 2005 to December 2019 in PubMed/MEDLINE, Embase, Science Direct, Scopus, and Cochrane Library using the following MeSH search terms alone or in combination: laparoscopic entry, laparoscopy access, pneumoperitoneum, Veress needle, open (Hasson), direct trocar, visual entry, shielded trocars, radially expanded trocars, and laparoscopic complications.

VALIDATION METHODS:

The authors rated the quality of evidence and strength of recommendations using the Canadian Task Force on Preventive Health Care approach (Appendix A).

INTENDED AUDIENCE:

Surgeons performing laparoscopic gynaecological surgery.

SUMMARY STATEMENTS:

RECOMMENDATIONS.

• Authors: George A Vilos, Artin Ternamian, Philippe Y Laberge, Angelos G Vilos, Basim Abu-Rafea, Sarah Scattolon, Nicholas Leyland
• Journal: Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC (J Obstet Gynaecol Can) Vol. 43 Issue 3 Pg. 376-389.e1 (03 2021) ISSN: 1701-2163 [Print] Netherlands
• PMID: 33373697 (Publication Type: Journal Article, Practice Guideline)
• Copyright: Copyright © 2021 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

Topics

• Canada
• Female
• Gynecologic Surgical Procedures (standards)
• Gynecology
• Humans
• Laparoscopy (adverse effects, methods, standards)
• Obstetrics
• Societies, Medical
• Surgical Instruments