Palmer's Point Versus The Umbilicus As Routine Primary Entry Site In Gynecologic Laparoscopy
试验速览
- 阶段
- 不适用
- 入组人数
- 96
- 试验地点
- 2
- 主要终点
- complications that occur in using the umbilicus method as the primary entry site in gynecological laparoscopy in comparison with Palmar's point
研究概览
简要总结
we will compare the classic method of using the umbilicus as the primary entry site in gynecological laparoscopy with Palmar's point
详细描述
All these cases will undergo:
- History taking Patients are randomly arranged in 2 groups Group (A):- Palmer's point is the primary entry site. The stomach will be emptied of secretions and air following endotracheal intubation. (This is most easily performed using a nasogastric tube.) The left upper quadrant will be inspected for scars and the upper abdomen palpated for hepatomegaly or splenomegaly. A 10-mm incision will be made over Palmer's point. Veress needle first will be used for insufflation and tests of safety will be considered.
A 10-mm port will be held vertically and the layers observed via a 10-mm laparoscope. A gentle rotating action in a vertical direction was used to allow the bladeless tip to separate the tissues.
The layers of the abdominal wall seen at Palmer's point are as follows:
- skin,
- subcutaneous fat,
- external oblique aponeurosis,
- internal oblique aponeurosis,
- transversalis muscle fibres,
- (sometimes) extraperitoneal fat,
- peritoneum. Once the peritoneum will be breached, the introducer will be carefully removed from the port. The laparoscope will be then reintroduced.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Investigator)
入排标准
- 年龄范围
- 10 Years 至 60 Years（Child, Adult）
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •Patients listed for diagnostic or operative laparoscopy.
排除标准
- •• Splenomegaly
- •Hepatomegaly
- •previous left upper quadrant surgery.
- •midline laparotomy
- •umbilical surgery
- •presence of umbilical hernia
结局指标
主要结局
complications that occur in using the umbilicus method as the primary entry site in gynecological laparoscopy in comparison with Palmar's point
时间窗: 6 months
we will compare the number of participants with vascular or intestinal injuries in both procedures
Time assessed by the difference in using the umbilicus method as the primary entry site in gynecological laparoscopy with Palmar's point
时间窗: 6 months
the surgeon will calculate the time of surgery for similar cases in both groups and will compare between both groups according to the time factor
coordination of the surgeon movement by the difference in using the umbilicus method as the primary entry site in gynecological laparoscopy in comparison with Palmar's point
时间窗: 6 months
questionnaire will be done to ask the surgeon about the degree of coordination and smoothness of using the surgeon his both hands in laparoscopy
次要结局
未报告次要终点
研究者
basem mohamed hamed khalil
lecturer of obstetrics and gynecology/ MD ob/gyn
Zagazig University