Assessment of the safety of the supraumbilical compression technique in closed laparoscopic entry

Aim: It was aimed to assess the safety of the external supraumbilical compression technique in closed entry in laparoscopy. Material and Method: In this prospective study, a total of 65 patients were randomised into 3 groups; Group 1 (n=22) with closed laparoscopic entry with an intraabdominal pressure (IAP) of 15 mmHg obtained by CO2 insufflation, Group 2 (n=22) with an IAP of 25 mmHg obtained by combined usage of supraumbilical compression and CO2 insufflation and Group 3 (n=21) with an IAP of 25 mmHg achieved by CO2 insufflation alone. Groups were compared in respect of the insufflated volume of CO2, pneumoperitoneum distances, operation onset-to-trocar entry interval, and surgical complications. Results: The pneumoperitoneum distance was determined as 8.4, 7, 11.2 cm in Groups 1, 2 and 3 respectively (p<0.001 in Groups 1 vs 2, Groups 2 vs 3, Groups 1 vs 3). Operation onset-to-trocar entry interval was 377.2, 365.4 and 463.5 seconds in Groups 1, 2 and 3 respectively (p<0.001 in Groups 1 vs 3 and Groups 2 vs 3, p=0.838 in Groups 1 vs 2). Insufflated volume of CO2 in Group 2 was statistically significantly higher compared to Gropus 1 and 2 (p < 0.001 in Groups 1 vs 3 and Groups 2 vs 3). Groups were statistically similar regarding the rate of surgical complications (p=0.128). Discussion: Compare to classic closed entry techniques, the external compression technique is associated with a shortened pneumoperitoneum distance which may result in a potential decrease in its safety.