A comparative study of open versus closed method of establishment of pneumoperitoneum in laparoscopic surgery

Background: Laparoscopy has overtaken open surgery as the choice of procedure wherever feasible. More than 50% of complications in laparoscopy occur during creation of pneumoperitoneum. In this study, we are comparing open or Hasson's method and closed or vress method of creation of pneumoperitoneum. Methods: This is a prospective comparative parallel randomised control trial conducted at the Department of Surgery, Baroda Medical College and SSG Hospital from November, 2017 to November, 2018. We divided the patients (n=100) into two groups i.e., open method (group O) (n1=50) and closed method (group C) (n2=50) groups using the envelope method of randomisation. We compared the two techniques in terms of time required to complete the procedures and complications (major and minor) associated with creation of pneumoperitoneum. Results: All the patients that participated in this study belonged to the age group of 10-69 years out of which majority were 15-50 years old. In our study, the mean time required to create pneumoperitoneum by closed method (group C) was 9.3 seconds while by open method (group O), it was 7.84 seconds with p value <0.001. There were 15 cases of gas leak from the port side, all recorded in the open method of establishment of pneumoperitoneum. Conclusions: Even though the open method takes less time to create pneumoperitoneum, both methods are similar in terms of time taken to complete the operation and major and minor complications because there was no statistically significant difference in the frequency of these parameters between the two techniques.