LAPROSCOPIC ENTRY: SAFETY AND EFFICACY OF DIRECT TROCAR TECHNIQUE WITHOUT PRIOR PNEUMOPERITONEUM VS VERRES NEEDLE TECHNIQUE IN LAPAROSCOPIC GYNAECOLOGICAL SURGERY IN A TERTIARY CARE HOSPITAL SETTING:A RANDOMIZED CLINICAL TRIAL:

The purpose of our study was to compare whether DTI umbilical entry can be a safe and effective alternate to enter abdominal cavity as compared to insertion after prior pneumoperitoneum as in conventionally practiced VN technique in patients undergoing various gynecologic laparoscopic procedures. STUDY DESIGN: Randomized clinical trial. SETTING: Department of OBGYN PGMI/AMC/LGH Lahore, over a period of two years from Feb 2018 to March 2020. SUBJECTS AND METHODS: It was performed on 150 patients admitted for either diagnostic or operative laparoscopic procedures. These patients were randomly allocated to either DTI (n=75) or VN(n=75). Procedure was performed by highly experienced consultant gynecologist trained in laparoscopy OUTCOME MEASURES: Visceral and Vascular injury Time taken for laparoscope entry into abdomen RESULTS: No major complication was observed in both techniques. 1.3% complication rate was noted in DTI technique while 5.3 % of patients suffered minor complications in VN technique. Mean time for laparoscopic entry was less in DTI technique (1.79+- 2.39 min) than in VN technique (3.63+- 0.64 min) p<0.001 CONCLUSION DTI technique is a safer one step effective and faster technique for laparoscopic entry in comparison to conventional VN technique with additional advantage of eliminating complications related to VN technique.