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J Hum Reprod Sci


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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