Modified Open Technique: A Safe Approach for Laparoscopic Entry

Objective: To describe the safety of the modified open technique for accessing the abdominal cavity and creation of pneumoperitoneum in gynecologic laparoscopy. Methods: A descriptive retrospective chart review of 100 patients who underwent gynecologic laparoscopy at the Jordanian Royal Medical Services Hospitals during the period from January 2008 to December 2009 was conducted. We used the modified open approach in all patients. This method consists of a 1-1.5cm vertical umbilical incision, dissection of the underlying structures to expose and incise the fascia. At this point, the peritoneum was opened and then a 10-mm trocar was introduced into the peritoneal cavity. Simple analytical method (frequency and percentage) was used to describe the complication rates. Results: There were no reported major intra-operative vascular or bowel injuries related to entry. Three patients had minor intra-operative complications (two cases of pre-peritoneal trocar placement and one patient had omental bleeding). The recorded post-operative complications included two cases of port-site infection and two cases of port-site hematoma. No cases of non-cosmetic healing, incisional hernia or gas embolism were reported. Conclusion: Our results suggest that the modified open technique is a safe approach for laparoscopic entry into the abdominal cavity with few minor intra-operative and post-operative complications.