Comparative Study on the Safety and Efficacy of Laparoscopic Access After Veress Needle Insufflation at Palmer's Point Versus Umbilical Location in Gynecological Surgery: Analytical Research

Objective: The aim of the study was to determine whether Palmer's point (PP) is a safer and more effective location than the umbilicus for elective insufflation with a Veress needle in laparoscopic access maneuvers. Material and Methods: To this end, a prospective analytical cohort study was conducted to compare PP with the umbilicus for laparoscopic access. The study period covered October 2014- May 2023, and data was obtained from 750 patients who underwent gynecological laparoscopic surgery, with 375 patients in each of the 2 groups. Results: The results show that the risk of presenting a complication is almost 3-fold greater if the insufflation is performed in the umbilicus (adjusted odds ratio 2.91, 95% confidence interval 1.31-6.45; p=0.009). For the patients with no previous history of laparotomy, the risk of experiencing a complication during the access maneuver in PP was lower (1.8% vs. 5.8% in the umbilicus; p<0.05). Furthermore, for the patients with a history of abdominal surgery, the complication rate was significantly higher for the umbilicus (16% vs. 5.6% in PP; p<0.05). Conclusion: Based on these results, the conclusion is that the safety and efficacy of PP in women who undergo laparoscopic surgery is greater when compared with the umbilical location, even in patients with no prior history of abdominal surgery.