Journal of Human Reproductive Science
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ORIGINAL ARTICLE Table of Contents   
Year : 2022  |  Volume : 15  |  Issue : 3  |  Page : 300-306
E-Z point: A new safe and reproducible laparoscopic entry in the left upper quadrant using a Veress needle


1 Department of Minimally Invasive Gynecologic Surgery, Henry Ford Hospital, Detroit, Michigan, USA
2 Department of Minimally Invasive Gynecologic Surgery, Henry Ford Hospital; Department of Medical Education, Wayne State University School of Medicine, Detroit, Michigan; Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
3 Department of Minimally Invasive Gynecologic Surgery, Henry Ford Hospital; Department of Medical Education, Wayne State University School of Medicine, Detroit, Michigan, USA

Correspondence Address:
Dr. David Eisenstein
Department of Minimally Invasive Gynecologic Surgery, Henry Ford Hospital, 6777 W Maple Road, West Bloomfield, Michigan 48322
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jhrs.jhrs_70_22

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Background: Over half of all fatal complications occur during primary laparoscopic entry. In our practice, we developed a novel modification of closed LUQ entry at Palmer's point and designated it “E-Z” entry. Aims: To evaluate the risks and safety of left subcostal entry, a technique we have designated 'E-Z' entry at our institution. Settings and Design: A retrospective chart review was conducted at a tertiary care medical centre of patients who underwent laparoscopic procedures by a single surgeon known to perform left subcostal entry for the last 10 years, using the E-Z entry technique. Materials and Methods: Retrospective chart review and description of surgical technique. Statistical Analysis Used: Simple descriptive statistics and univariate two-group comparisons. Results: One hundred ninety-eight laparoscopic cases were identified as performed by a single surgeon in the last 10 years: 149 underwent umbilical entry and 49 underwent E-Z entry. The average number of previous abdominal surgeries was higher in the E-Z entry group compared to the umbilical group, 1.3 versus 0.5, respectively (P = 0.003). The umbilical entry group had no complications. One complication was noted with the E-Z entry technique, in which the Veress needle was noted to perforate the liver capsule but was managed expectantly. Conclusion: We propose the E-Z entry technique for Veress needle entry as an ergonomic and easily reproducible entry technique in the left upper quadrant in the setting of suspected intraperitoneal adhesions.


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