Describe the different techniques of creating pneumoperitoneum during laparoscopic surgery.
Creating a pneumoperitoneum, or gas-filled abdominal cavity, is essential for laparoscopic surgery.
Closed Technique (Veress Needle): A small incision allows blind insertion of a spring-loaded Veress needle. Placement is confirmed via tests, then CO2 is insufflated to 12–15 mmHg. Fast but carries a small risk of visceral or vascular injury.
Open Technique (Hassan): Safer for patients with prior surgeries or adhesions. The peritoneum is exposed under direct vision, and a blunt cannula is inserted before CO2 insufflation. Minimizes blind-entry risks but takes more time.
Direct Trocar Insertion: For select patients, a sharp trocar is inserted directly, often with optical guidance. Quick but requires expertise to avoid injury.
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