Surgical Endoscopy And Other Interventional Techniques

, Volume 16, Issue 12, pp 1796–1801

Safe laparoscopic adhesiolysis with optical access trocar and ultrasonic dissection

  • D.J. Swank
  • H.J. Bonjer
  • J. Jeekel

DOI: 10.1007/s00464-002-9021-5

Cite this article as:
Swank, D., Bonjer, H. & Jeekel, J. Surg Endosc (2002) 16: 1796. doi:10.1007/s00464-002-9021-5

Background: The objective of this clinical study was to examine the feasibility, safety, and adequacy of hemostasis of combined use of an optical trocar and ultrasonic dissection in laparoscopic adhesiolysis in patients with chronic abdominal pain. Methods: In 105 patients, identification of anatomic layers of the abdominal wall, establishment of pneumoperitoneum, completeness of adhesiolysis, hemostasis, and complications and pain relief were studied. Results: All abdominal wall layers could be determined during introduction as well as adherence of intraabdominal organs at the introduction site. Ultrasonic dissection enables an (almost) complete adhesiolysis in 103 (98%) patients and offered adequate hemostasis in 101 (96%) patients. Four perforations during laparoscopic adhesiolysis and no late (thermal) perforations were observed. Conclusions: With an optical trocar a safe introduction site of the abdominal wall can be chosen. The ultrasonic technique offers a sound adhesiolysis with adequate hemostasis and fewer thermal perforations and adds to feasibility and safety of laparoscopic adhesiolysis.

Copyright information

© 2002 Springer-Verlag New York Inc.

Authors and Affiliations

  • D.J. Swank
    • 1
  • H.J. Bonjer
    • 2
  • J. Jeekel
    • 2
  1. 1.Department of Surgery, Groene Hart Hospital, Post Office Box 1098, 2800 BB Gouda, The NetherlandsNL
  2. 2.Department of Surgery, Erasmus University Medical Centre Rotterdam, Post Office Box 2070, 3000 CB Rotterdam, The NetherlandsNL

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