Open laparoscopy utilizing either a 5 mm or 10 mm standard intra-umbilical trocar

Objective: To describe a technique for open entry for laparoscopic procedures, utilizing either a standard 5- or 10 mm trocar through an 8- or 12 mm intra-umbilical incision, respectively. Settings: Two teaching hospitals. Subjects: A total of 237 patients. The first 186 patients had a 10-mm trocar inserted, and the latter 51 patients a 5-mm trocar entry. Results: The average time required to achieve pneumoperitoneum was 3.5 min with no complications encountered. Gas leakage overall occurred in 4.2% of patients, though in no case was remedial fascial suturing required. There were two cases of wound infection (0.8%), including an infected umbilical haemotoma. All minor complications occurred in the first 20 patients undergoing surgery. Conclusion: Open laparoscopy using this technique is safe, quick, and cosmetically excellent with minimal complications and no major disadvantages. It provides an improved safety margin for vascular injury in comparison to closed peritoneal entry, though it is theoretically capable of causing type II visceral injuries.