Laparoscopic entry techniques: clinical guideline, national survey, and medicolegal ramifications
- Rajesh VarmaAffiliated withDepartment of Women’s Health, Guy’s and St. Thomas’ NHS Foundation Trust, St. Thomas’ Hospital Email author
- , Janesh K. GuptaAffiliated withDepartment of Obstetrics and Gynaecology, Birmingham Women’s Hospital
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
This study aimed to establish criteria for safe laparoscopic entry through a systematic literature search and evidence-based medicine appraisal, to determine surgeon preferences for laparoscopic entry in the United Kingdom, and to appraise the medicolegal ramifications of complications arising from laparoscopic entry.
A systematic literature search of MEDLINE and EMBASE (1996–2007) was performed as well as a national surgeon survey by questionnaire (May–December 2006).
Laparoscopic entry criteria involving 10 steps were established based on the systematic literature search and evidence-based critical appraisal. The national survey had 226 respondents, with the majority aware of the Middlesbrough consensus or Royal College of Obstetricians and Gynaecologists [RCOG]-sourced guidance. There was considerable variation in preferred laparoscopic entry techniques. Currently, there is clear judicial guidance on the medicolegal stance toward laparoscopic entry-related complications.
Despite widespread awareness of laparoscopic entry guidelines, there remains considerable variation in the techniques adopted in clinical practice. Unless practice concurs with recommended guidance, women undergoing laparoscopy will be exposed to increased unnecessary operative risk. Laparoscopic entry-related injury in an uncomplicated woman is considered negligent practice according to UK legal case law.
KeywordsLaparoscopic entry Guidelines Laparoscopy Pneumoperitoneum Artificial Surgical procedures Minimally invasive Intraoperative complications
- Laparoscopic entry techniques: clinical guideline, national survey, and medicolegal ramifications
Volume 22, Issue 12 , pp 2686-2697
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Laparoscopic entry
- Surgical procedures
- Minimally invasive
- Intraoperative complications
- Industry Sectors
- Author Affiliations
- 1. Department of Women’s Health, Guy’s and St. Thomas’ NHS Foundation Trust, St. Thomas’ Hospital, 10th Floor, North Wing, Westminster Bridge Road, London, SE1 7EH, UK
- 2. Department of Obstetrics and Gynaecology, Birmingham Women’s Hospital, 2nd Floor, Birmingham, B15 2TG, UK