LE COMPLICANZE NELLA CREAZIONE DEL PNEUMOPERITONEO: RISULTATI DI UNA INDAGINE RETROSPETTIVA POLICENTRICA

Laparoscopic surgery has had an enormous developement. Some complications, that can even be extremely severe, are specifically related to this approach. Among them are complications occurring during the creation of pneumoperitoneum. Both the open and closed techniques have been described for access to the abdominal cavity. Most surgeons prefer the routine use of the closed technique, reserving the open approach for selected cases. However some have argued that the close approach may carry a higher risk of severe complications. We reviewed 6132 cases of surgical laparoscopies performed in 8 Italian Centers between 1989 and 1993, after the availability of disposable trocars and needles. The complications of the open and closed techniques for the creation of pneumoperitoneum were compared. The results of the study showed that the incidence of complications related both to the open and closed technique for PNP creation is low. However no severe complication, requiring major treatment, was observed in patients operated on with an open technique. Some of the complications observed when a closed technique was used were clinically severe.