The feasibility of direct insertion without previous pneumoperitoneum after prior abdominal surgery

【Objective】To evaluate the safety and feasibility of the first direct trocar insertion without previous pneumoperitoneum to the patient which had previous abdominal operations.【Methods】412 cases with laparoscopic surgery were investigated,202 cases had previous abdominal operations and 210 cases were the first time to have surgery.The trocar related injurys and the adhesion in the body were calculated.【Results】75 in 202 cases(37.1%) had peritoneal adhesions,the insertion time is(1.01 ± 0.92) min.there was no complication in these cases.For the control group the insertion time is(1.08 ± 0.56) min,(P0.05),Only one patient had a omentum injury.【Conclusions】 The first direct trocar insertion technique provides safe entry into the peritoneal cavity in patients which had previous abdominal operations.