Assessing Open versus Closed Techniques for Pneumoperitoneum Creation in Laparoscopic Surgery

Background and Aim: Research has consistently documented instances of visceral perforation across various studies employing both open and closed techniques. The condition is linked to a significant mortality rate, primarily because numerous injuries may go unrecognized during surgical procedures. This study was conducted to assess the effectiveness of open versus closed techniques for intraperitoneal access in creating pneumoperitoneum during laparoscopic surgery. Material and Methods: The study included all patients undergoing abdominal laparoscopic surgeries, specifically those aged between 18 and 70 years, regardless of gender. The study involved fifty patients who underwent laparoscopic cholecystectomies and decision to divide the patients into two groups was made with careful consideration of the surgeon’s preference and expertise, resulting in 25 patients being assigned to either the open or closed method for creating pneumoperitoneum. To assess the score for Surgical Site Infection (SSI), the Southampton Wound Scoring System was employed, and the Visual Analogue Scale was used to measure the pain level experienced at the port site. Results: The time taken to close the umbilical port differed between the two groups, with the open group averaging 5.3 ± 12.1 minutes and the closed group averaging 6.4 ± 09.4 minutes. Our study revealed that the average time taken to close the umbilical port was 8.12 ± 0.24 minutes for the open group, compared to 9.22 ± 3.54 minutes for the closed group. The difference observed was found to be highly statistically significant. Conclusion: In the context of laparoscopic cholecystectomy, our findings indicate that the open technique provides faster access to the pneumoperitoneum compared to the closed approach when evaluated under similar conditions.